Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE COMPRESSION 4 HOLE

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270679503
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,314.50
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

PLATE COMPRS 10 HOLE 130-150DG

Facility

$1,849.00

Hospital Charge Code	1605732
Hospital Revenue Code	274
Min. Negotiated Rate	$277.35
Max. Negotiated Rate	$447.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$369.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$406.78
Rate for Payer: Qualcare PPO/HMO/WC	$277.35

PLATE COMPRS 10 HOLE 130-150DG

Facility

$1,849.00

Hospital Charge Code	1605732
Hospital Revenue Code	274
Min. Negotiated Rate	$44.56
Max. Negotiated Rate	$924.50
Rate for Payer: Aetna Commercial	$702.62
Rate for Payer: Aetna Medicare Advantage	$554.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$369.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.50
Rate for Payer: Cigna Commercial	$924.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$406.78
Rate for Payer: Qualcare PPO/HMO/WC	$277.35
Rate for Payer: UnitedHealthcare Community & State	$44.56
Rate for Payer: Wellpoint Medicaid Managed Care	$49.00

PLATE COMPRS 12 HOLE 130-150DG

Facility

$1,964.00

Hospital Charge Code	1605724
Hospital Revenue Code	274
Min. Negotiated Rate	$294.60
Max. Negotiated Rate	$475.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$432.08
Rate for Payer: Qualcare PPO/HMO/WC	$294.60

PLATE COMPRS 12 HOLE 130-150DG

Facility

$1,964.00

Hospital Charge Code	1605724
Hospital Revenue Code	274
Min. Negotiated Rate	$47.33
Max. Negotiated Rate	$982.00
Rate for Payer: Aetna Commercial	$746.32
Rate for Payer: Aetna Medicare Advantage	$589.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$500.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$500.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$500.82
Rate for Payer: Cigna Commercial	$982.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$432.08
Rate for Payer: Qualcare PPO/HMO/WC	$294.60
Rate for Payer: UnitedHealthcare Community & State	$47.33
Rate for Payer: Wellpoint Medicaid Managed Care	$52.05

PLATE COMPRS 14 HOLE 130-150DG

Facility

$2,392.00

Hospital Charge Code	1605716
Hospital Revenue Code	274
Min. Negotiated Rate	$57.65
Max. Negotiated Rate	$1,196.00
Rate for Payer: Aetna Commercial	$908.96
Rate for Payer: Aetna Medicare Advantage	$717.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$609.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$609.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$609.96
Rate for Payer: Cigna Commercial	$1,196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.24
Rate for Payer: Qualcare PPO/HMO/WC	$358.80
Rate for Payer: UnitedHealthcare Community & State	$57.65
Rate for Payer: Wellpoint Medicaid Managed Care	$63.39

PLATE COMPRS 14 HOLE 130-150DG

Facility

$2,392.00

Hospital Charge Code	1605716
Hospital Revenue Code	274
Min. Negotiated Rate	$358.80
Max. Negotiated Rate	$578.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.24
Rate for Payer: Qualcare PPO/HMO/WC	$358.80

PLATE COMPRS 2 HOLE 130-150DEG

Facility

$1,111.00

Hospital Charge Code	1605799
Hospital Revenue Code	274
Min. Negotiated Rate	$166.65
Max. Negotiated Rate	$268.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.42
Rate for Payer: Qualcare PPO/HMO/WC	$166.65

PLATE COMPRS 2 HOLE 130-150DEG

Facility

$1,111.00

Hospital Charge Code	1605799
Hospital Revenue Code	274
Min. Negotiated Rate	$26.78
Max. Negotiated Rate	$555.50
Rate for Payer: Aetna Commercial	$422.18
Rate for Payer: Aetna Medicare Advantage	$333.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.31
Rate for Payer: Cigna Commercial	$555.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.42
Rate for Payer: Qualcare PPO/HMO/WC	$166.65
Rate for Payer: UnitedHealthcare Community & State	$26.78
Rate for Payer: Wellpoint Medicaid Managed Care	$29.44

PLATE COMPRS 3 HOLE 130-150DEG

Facility

$1,171.00

Hospital Charge Code	1605781
Hospital Revenue Code	274
Min. Negotiated Rate	$28.22
Max. Negotiated Rate	$585.50
Rate for Payer: Aetna Commercial	$444.98
Rate for Payer: Aetna Medicare Advantage	$351.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.61
Rate for Payer: Cigna Commercial	$585.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$257.62
Rate for Payer: Qualcare PPO/HMO/WC	$175.65
Rate for Payer: UnitedHealthcare Community & State	$28.22
Rate for Payer: Wellpoint Medicaid Managed Care	$31.03

PLATE COMPRS 3 HOLE 130-150DEG

Facility

$1,171.00

Hospital Charge Code	1605781
Hospital Revenue Code	274
Min. Negotiated Rate	$175.65
Max. Negotiated Rate	$283.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$257.62
Rate for Payer: Qualcare PPO/HMO/WC	$175.65

PLATE COMPRS 4 HOLE 130-150DEG

Facility

$1,206.00

Hospital Charge Code	1605773
Hospital Revenue Code	274
Min. Negotiated Rate	$29.06
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$458.28
Rate for Payer: Aetna Medicare Advantage	$361.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.53
Rate for Payer: Cigna Commercial	$603.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.32
Rate for Payer: Qualcare PPO/HMO/WC	$180.90
Rate for Payer: UnitedHealthcare Community & State	$29.06
Rate for Payer: Wellpoint Medicaid Managed Care	$31.96

PLATE COMPRS 4 HOLE 130-150DEG

Facility

$1,206.00

Hospital Charge Code	1605773
Hospital Revenue Code	274
Min. Negotiated Rate	$180.90
Max. Negotiated Rate	$291.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$265.32
Rate for Payer: Qualcare PPO/HMO/WC	$180.90

PLATE COMPRS 5 HOLE 130-150DEG

Facility

$1,246.00

Hospital Charge Code	1605765
Hospital Revenue Code	274
Min. Negotiated Rate	$186.90
Max. Negotiated Rate	$301.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$274.12
Rate for Payer: Qualcare PPO/HMO/WC	$186.90

PLATE COMPRS 5 HOLE 130-150DEG

Facility

$1,246.00

Hospital Charge Code	1605765
Hospital Revenue Code	274
Min. Negotiated Rate	$30.03
Max. Negotiated Rate	$623.00
Rate for Payer: Aetna Commercial	$473.48
Rate for Payer: Aetna Medicare Advantage	$373.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.73
Rate for Payer: Cigna Commercial	$623.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$274.12
Rate for Payer: Qualcare PPO/HMO/WC	$186.90
Rate for Payer: UnitedHealthcare Community & State	$30.03
Rate for Payer: Wellpoint Medicaid Managed Care	$33.02

PLATE COMPRS 6 HOLE 130-150DEG

Facility

$1,281.00

Hospital Charge Code	1605757
Hospital Revenue Code	274
Min. Negotiated Rate	$30.87
Max. Negotiated Rate	$640.50
Rate for Payer: Aetna Commercial	$486.78
Rate for Payer: Aetna Medicare Advantage	$384.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.65
Rate for Payer: Cigna Commercial	$640.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$281.82
Rate for Payer: Qualcare PPO/HMO/WC	$192.15
Rate for Payer: UnitedHealthcare Community & State	$30.87
Rate for Payer: Wellpoint Medicaid Managed Care	$33.95

PLATE COMPRS 6 HOLE 130-150DEG

Facility

$1,281.00

Hospital Charge Code	1605757
Hospital Revenue Code	274
Min. Negotiated Rate	$192.15
Max. Negotiated Rate	$310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$281.82
Rate for Payer: Qualcare PPO/HMO/WC	$192.15

PLATE COMPRS 8 HOLE 130-150DEG

Facility

$1,595.00

Hospital Charge Code	1605740
Hospital Revenue Code	274
Min. Negotiated Rate	$239.25
Max. Negotiated Rate	$385.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$239.25

PLATE COMPRS 8 HOLE 130-150DEG

Facility

$1,595.00

Hospital Charge Code	1605740
Hospital Revenue Code	274
Min. Negotiated Rate	$38.44
Max. Negotiated Rate	$797.50
Rate for Payer: Aetna Commercial	$606.10
Rate for Payer: Aetna Medicare Advantage	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.73
Rate for Payer: Cigna Commercial	$797.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$239.25
Rate for Payer: UnitedHealthcare Community & State	$38.44
Rate for Payer: Wellpoint Medicaid Managed Care	$42.27

PLATECOMPVALCP2.8/3.5X169MM8H

Facility

$5,896.20

Service Code	HCPCS C1713
Hospital Charge Code	270698571
Hospital Revenue Code	278
Min. Negotiated Rate	$142.10
Max. Negotiated Rate	$2,948.10
Rate for Payer: Aetna Commercial	$2,240.56
Rate for Payer: Aetna Medicare Advantage	$1,768.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,503.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,503.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,503.53
Rate for Payer: Cigna Commercial	$2,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,297.16
Rate for Payer: Qualcare PPO/HMO/WC	$884.43
Rate for Payer: UnitedHealthcare Community & State	$142.10
Rate for Payer: Wellpoint Medicaid Managed Care	$156.25

PLATECOMPVALCP2.8/3.5X169MM8H

Facility

$5,896.20

Service Code	HCPCS C1713
Hospital Charge Code	270698571
Hospital Revenue Code	278
Min. Negotiated Rate	$884.43
Max. Negotiated Rate	$1,426.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,297.16
Rate for Payer: Qualcare PPO/HMO/WC	$884.43

PLATE CONDYLAR 10H 230MM RT S

Facility

$7,545.00

Service Code	HCPCS C1713
Hospital Charge Code	270675713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,131.75
Max. Negotiated Rate	$1,825.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,509.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,825.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,659.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,131.75

PLATE CONDYLAR 10H 230MM RT S

Facility

$7,545.00

Service Code	HCPCS C1713
Hospital Charge Code	270675713
Hospital Revenue Code	278
Min. Negotiated Rate	$181.83
Max. Negotiated Rate	$3,772.50
Rate for Payer: Aetna Commercial	$2,867.10
Rate for Payer: Aetna Medicare Advantage	$2,263.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,923.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,923.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,923.97
Rate for Payer: Cigna Commercial	$3,772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,825.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,659.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,131.75
Rate for Payer: UnitedHealthcare Community & State	$181.83
Rate for Payer: Wellpoint Medicaid Managed Care	$199.94

PLATE CONDYLAR 159MM 6H LT STR

Facility

$7,083.00

Service Code	HCPCS C1713
Hospital Charge Code	270675839
Hospital Revenue Code	278
Min. Negotiated Rate	$170.70
Max. Negotiated Rate	$3,541.50
Rate for Payer: Aetna Commercial	$2,691.54
Rate for Payer: Aetna Medicare Advantage	$2,124.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,806.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,806.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,416.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,806.16
Rate for Payer: Cigna Commercial	$3,541.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,714.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,558.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,062.45
Rate for Payer: UnitedHealthcare Community & State	$170.70
Rate for Payer: Wellpoint Medicaid Managed Care	$187.70

PLATE CONDYLAR 159MM 6H LT STR

Facility

$7,083.00

Service Code	HCPCS C1713
Hospital Charge Code	270675839
Hospital Revenue Code	278
Min. Negotiated Rate	$1,062.45
Max. Negotiated Rate	$1,714.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,416.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,714.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,558.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,062.45

Know your out-of-pocket cost for care.

All Charges