Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DCP 3.5MM 4H

Facility

$442.45

Hospital Charge Code	270604396
Hospital Revenue Code	278
Min. Negotiated Rate	$66.37
Max. Negotiated Rate	$107.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.34
Rate for Payer: Qualcare PPO/HMO/WC	$66.37

PLATE DCP 3.5MM 5H

Facility

$481.65

Hospital Charge Code	270604397
Hospital Revenue Code	278
Min. Negotiated Rate	$72.25
Max. Negotiated Rate	$116.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.96
Rate for Payer: Qualcare PPO/HMO/WC	$72.25

PLATE DCP 3.5MM 5H

Facility

$481.65

Hospital Charge Code	270604397
Hospital Revenue Code	278
Min. Negotiated Rate	$11.61
Max. Negotiated Rate	$240.82
Rate for Payer: Aetna Commercial	$183.03
Rate for Payer: Aetna Medicare Advantage	$144.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.82
Rate for Payer: Cigna Commercial	$240.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.96
Rate for Payer: Qualcare PPO/HMO/WC	$72.25
Rate for Payer: UnitedHealthcare Community & State	$11.61
Rate for Payer: Wellpoint Medicaid Managed Care	$12.76

PLATE DCP 3.5MM 6H

Facility

$508.00

Hospital Charge Code	270604398
Hospital Revenue Code	278
Min. Negotiated Rate	$76.20
Max. Negotiated Rate	$122.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.76
Rate for Payer: Qualcare PPO/HMO/WC	$76.20

PLATE DCP 3.5MM 6H

Facility

$508.00

Hospital Charge Code	270604398
Hospital Revenue Code	278
Min. Negotiated Rate	$12.24
Max. Negotiated Rate	$254.00
Rate for Payer: Aetna Commercial	$193.04
Rate for Payer: Aetna Medicare Advantage	$152.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.54
Rate for Payer: Cigna Commercial	$254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.76
Rate for Payer: Qualcare PPO/HMO/WC	$76.20
Rate for Payer: UnitedHealthcare Community & State	$12.24
Rate for Payer: Wellpoint Medicaid Managed Care	$13.46

PLATE DCP 3.5MM 7H

Facility

$530.45

Hospital Charge Code	270604399
Hospital Revenue Code	278
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$265.23
Rate for Payer: Aetna Commercial	$201.57
Rate for Payer: Aetna Medicare Advantage	$159.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.26
Rate for Payer: Cigna Commercial	$265.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57
Rate for Payer: UnitedHealthcare Community & State	$12.78
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

PLATE DCP 3.5MM 7H

Facility

$530.45

Hospital Charge Code	270604399
Hospital Revenue Code	278
Min. Negotiated Rate	$79.57
Max. Negotiated Rate	$128.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57

PLATE DCP 3.5MM 8H

Facility

$558.45

Hospital Charge Code	270604400
Hospital Revenue Code	278
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$135.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.86
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

PLATE DCP 3.5MM 8H

Facility

$558.45

Hospital Charge Code	270604400
Hospital Revenue Code	278
Min. Negotiated Rate	$13.46
Max. Negotiated Rate	$279.23
Rate for Payer: Aetna Commercial	$212.21
Rate for Payer: Aetna Medicare Advantage	$167.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.40
Rate for Payer: Cigna Commercial	$279.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.86
Rate for Payer: Qualcare PPO/HMO/WC	$83.77
Rate for Payer: UnitedHealthcare Community & State	$13.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

PLATE DCP 3.5MM 9H

Facility

$581.65

Hospital Charge Code	270604401
Hospital Revenue Code	278
Min. Negotiated Rate	$87.25
Max. Negotiated Rate	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.96
Rate for Payer: Qualcare PPO/HMO/WC	$87.25

PLATE DCP 3.5MM 9H

Facility

$581.65

Hospital Charge Code	270604401
Hospital Revenue Code	278
Min. Negotiated Rate	$14.02
Max. Negotiated Rate	$290.82
Rate for Payer: Aetna Commercial	$221.03
Rate for Payer: Aetna Medicare Advantage	$174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.32
Rate for Payer: Cigna Commercial	$290.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.96
Rate for Payer: Qualcare PPO/HMO/WC	$87.25
Rate for Payer: UnitedHealthcare Community & State	$14.02
Rate for Payer: Wellpoint Medicaid Managed Care	$15.41

PLATE DCP 6 HOLE 3.5x73MM

Facility

$645.00

Service Code	HCPCS C1713
Hospital Charge Code	270668575
Hospital Revenue Code	278
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$156.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

PLATE DCP 6 HOLE 3.5x73MM

Facility

$645.00

Service Code	HCPCS C1713
Hospital Charge Code	270668575
Hospital Revenue Code	278
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$322.50
Rate for Payer: Aetna Commercial	$245.10
Rate for Payer: Aetna Medicare Advantage	$193.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.47
Rate for Payer: Cigna Commercial	$322.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.75
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

PLATE DCP NARROW 4H 4.5x71MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651715
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

PLATE DCP NARROW 4H 4.5x71MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651715
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

PLATE DCP NARROW 5H 4.5x87MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651716
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

PLATE DCP NARROW 5H 4.5x87MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651716
Hospital Revenue Code	278
Min. Negotiated Rate	$14.97
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.64
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$14.97
Rate for Payer: Wellpoint Medicaid Managed Care	$16.46

PLATE DCP NARROW 6H 103MM

Facility

$687.00

Hospital Charge Code	270671823
Hospital Revenue Code	278
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$343.50
Rate for Payer: Aetna Commercial	$261.06
Rate for Payer: Aetna Medicare Advantage	$206.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.19
Rate for Payer: Cigna Commercial	$343.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.14
Rate for Payer: Qualcare PPO/HMO/WC	$103.05
Rate for Payer: UnitedHealthcare Community & State	$16.56
Rate for Payer: Wellpoint Medicaid Managed Care	$18.21

PLATE DCP NARROW 6H 103MM

Facility

$687.00

Hospital Charge Code	270671823
Hospital Revenue Code	278
Min. Negotiated Rate	$103.05
Max. Negotiated Rate	$166.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.14
Rate for Payer: Qualcare PPO/HMO/WC	$103.05

PLATE DCP NARROW 8H 4.5x135MM

Facility

$707.60

Service Code	HCPCS C1713
Hospital Charge Code	270651717
Hospital Revenue Code	278
Min. Negotiated Rate	$106.14
Max. Negotiated Rate	$171.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.67
Rate for Payer: Qualcare PPO/HMO/WC	$106.14

PLATE DCP NARROW 8H 4.5x135MM

Facility

$707.60

Service Code	HCPCS C1713
Hospital Charge Code	270651717
Hospital Revenue Code	278
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$353.80
Rate for Payer: Aetna Commercial	$268.89
Rate for Payer: Aetna Medicare Advantage	$212.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.44
Rate for Payer: Cigna Commercial	$353.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.67
Rate for Payer: Qualcare PPO/HMO/WC	$106.14
Rate for Payer: UnitedHealthcare Community & State	$17.05
Rate for Payer: Wellpoint Medicaid Managed Care	$18.75

PLATE DCP TT 2.0MM 5H

Facility

$920.00

Hospital Charge Code	270604093
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$222.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$202.40
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

PLATE DCP TT 2.0MM 5H

Facility

$920.00

Hospital Charge Code	270604093
Hospital Revenue Code	278
Min. Negotiated Rate	$22.17
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$202.40
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Community & State	$22.17
Rate for Payer: Wellpoint Medicaid Managed Care	$24.38

PLATE DCP TT 2.0MM 8H

Facility

$1,180.85

Hospital Charge Code	270604096
Hospital Revenue Code	278
Min. Negotiated Rate	$177.13
Max. Negotiated Rate	$285.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$259.79
Rate for Payer: Qualcare PPO/HMO/WC	$177.13

PLATE DCP TT 2.0MM 8H

Facility

$1,180.85

Hospital Charge Code	270604096
Hospital Revenue Code	278
Min. Negotiated Rate	$28.46
Max. Negotiated Rate	$590.42
Rate for Payer: Aetna Commercial	$448.72
Rate for Payer: Aetna Medicare Advantage	$354.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.12
Rate for Payer: Cigna Commercial	$590.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$259.79
Rate for Payer: Qualcare PPO/HMO/WC	$177.13
Rate for Payer: UnitedHealthcare Community & State	$28.46
Rate for Payer: Wellpoint Medicaid Managed Care	$31.29

Know your out-of-pocket cost for care.

All Charges