Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DHS ST BAR 5 HL 130 DEG

Facility

$1,932.00

Hospital Charge Code	270603804
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS ST BAR 5 HL 130 DEG

Facility

$1,932.00

Hospital Charge Code	270603804
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS ST BAR 6 HL 130 DEG

Facility

$1,932.00

Hospital Charge Code	270603805
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS ST BAR 6 HL 130 DEG

Facility

$1,932.00

Hospital Charge Code	270603805
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DIS RAD 3 HOLE RIGHT

Facility

$12,550.00

Hospital Charge Code	270703505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,882.50
Max. Negotiated Rate	$3,037.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,037.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,761.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,882.50

PLATE DIS RAD 3 HOLE RIGHT

Facility

$12,550.00

Hospital Charge Code	270703505
Hospital Revenue Code	278
Min. Negotiated Rate	$302.45
Max. Negotiated Rate	$6,275.00
Rate for Payer: Aetna Commercial	$4,769.00
Rate for Payer: Aetna Medicare Advantage	$3,765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,200.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,200.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,200.25
Rate for Payer: Cigna Commercial	$6,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,037.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,761.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,882.50
Rate for Payer: UnitedHealthcare Community & State	$302.45
Rate for Payer: Wellpoint Medicaid Managed Care	$332.57

PLATE DISTAL 2.7/3 5MM RT 8 HO

Facility

$6,804.60

Service Code	HCPCS C1713
Hospital Charge Code	270685244
Hospital Revenue Code	278
Min. Negotiated Rate	$163.99
Max. Negotiated Rate	$3,402.30
Rate for Payer: Aetna Commercial	$2,585.75
Rate for Payer: Aetna Medicare Advantage	$2,041.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.17
Rate for Payer: Cigna Commercial	$3,402.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.69
Rate for Payer: UnitedHealthcare Community & State	$163.99
Rate for Payer: Wellpoint Medicaid Managed Care	$180.32

PLATE DISTAL 2.7/3 5MM RT 8 HO

Facility

$6,804.60

Service Code	HCPCS C1713
Hospital Charge Code	270685244
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.69
Max. Negotiated Rate	$1,646.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.69

PLATE DISTAL 2.7 MM 8 HOLE

Facility

$6,804.60

Service Code	HCPCS C1713
Hospital Charge Code	270680966
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.69
Max. Negotiated Rate	$1,646.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.69

PLATE DISTAL 2.7 MM 8 HOLE

Facility

$6,804.60

Service Code	HCPCS C1713
Hospital Charge Code	270680966
Hospital Revenue Code	278
Min. Negotiated Rate	$163.99
Max. Negotiated Rate	$3,402.30
Rate for Payer: Aetna Commercial	$2,585.75
Rate for Payer: Aetna Medicare Advantage	$2,041.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.17
Rate for Payer: Cigna Commercial	$3,402.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.69
Rate for Payer: UnitedHealthcare Community & State	$163.99
Rate for Payer: Wellpoint Medicaid Managed Care	$180.32

PLATE DISTAL 6HOLE 27234

Facility

$5,940.00

Hospital Charge Code	270639676
Hospital Revenue Code	278
Min. Negotiated Rate	$891.00
Max. Negotiated Rate	$1,437.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$891.00

PLATE DISTAL 6HOLE 27234

Facility

$5,940.00

Hospital Charge Code	270639676
Hospital Revenue Code	278
Min. Negotiated Rate	$143.15
Max. Negotiated Rate	$2,970.00
Rate for Payer: Aetna Commercial	$2,257.20
Rate for Payer: Aetna Medicare Advantage	$1,782.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,514.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,514.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,514.70
Rate for Payer: Cigna Commercial	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$891.00
Rate for Payer: UnitedHealthcare Community & State	$143.15
Rate for Payer: Wellpoint Medicaid Managed Care	$157.41

PLATE DISTAL CLAVICLE 70MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687755
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 DISTAL CLAVICLE 70MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687755
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 DISTAL FEMORA R 3H 122mm

Facility

$7,500.00

Hospital Charge Code	270671122
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

PLATE DISTAL FEMORA R 3H 122mm

Facility

$7,500.00

Hospital Charge Code	270671122
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PLATE DISTAL FEMUR 5H 156MM LF

Facility

$6,804.00

Hospital Charge Code	270674359
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$1,646.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,496.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE DISTAL FEMUR 5H 156MM LF

Facility

$6,804.00

Hospital Charge Code	270674359
Hospital Revenue Code	278
Min. Negotiated Rate	$163.98
Max. Negotiated Rate	$3,402.00
Rate for Payer: Aetna Commercial	$2,585.52
Rate for Payer: Aetna Medicare Advantage	$2,041.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.02
Rate for Payer: Cigna Commercial	$3,402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,496.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60
Rate for Payer: UnitedHealthcare Community & State	$163.98
Rate for Payer: Wellpoint Medicaid Managed Care	$180.31

PLATE DISTAL FEMUR 6H LF 166MM

Facility

$9,824.10

Service Code	HCPCS C1713
Hospital Charge Code	270673222
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.62
Max. Negotiated Rate	$2,377.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,964.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.62

PLATE DISTAL FEMUR 6H LF 166MM

Facility

$9,824.10

Service Code	HCPCS C1713
Hospital Charge Code	270673222
Hospital Revenue Code	278
Min. Negotiated Rate	$236.76
Max. Negotiated Rate	$4,912.05
Rate for Payer: Aetna Commercial	$3,733.16
Rate for Payer: Aetna Medicare Advantage	$2,947.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,964.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.15
Rate for Payer: Cigna Commercial	$4,912.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.62
Rate for Payer: UnitedHealthcare Community & State	$236.76
Rate for Payer: Wellpoint Medicaid Managed Care	$260.34

PLATE DISTAL FEMUR LEFT

Facility

$5,379.00

Hospital Charge Code	270668421
Hospital Revenue Code	278
Min. Negotiated Rate	$129.63
Max. Negotiated Rate	$2,689.50
Rate for Payer: Aetna Commercial	$2,044.02
Rate for Payer: Aetna Medicare Advantage	$1,613.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,371.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,371.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,371.64
Rate for Payer: Cigna Commercial	$2,689.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,301.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,183.38
Rate for Payer: Qualcare PPO/HMO/WC	$806.85
Rate for Payer: UnitedHealthcare Community & State	$129.63
Rate for Payer: Wellpoint Medicaid Managed Care	$142.54

PLATE DISTAL FEMUR LEFT

Facility

$5,379.00

Hospital Charge Code	270668421
Hospital Revenue Code	278
Min. Negotiated Rate	$806.85
Max. Negotiated Rate	$1,301.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,301.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,183.38
Rate for Payer: Qualcare PPO/HMO/WC	$806.85

PLATE DISTAL FEMUR RT 6 HOLE

Facility

$12,730.00

Hospital Charge Code	270668436
Hospital Revenue Code	278
Min. Negotiated Rate	$1,909.50
Max. Negotiated Rate	$3,080.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,080.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,800.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,909.50

PLATE DISTAL FEMUR RT 6 HOLE

Facility

$12,730.00

Hospital Charge Code	270668436
Hospital Revenue Code	278
Min. Negotiated Rate	$306.79
Max. Negotiated Rate	$6,365.00
Rate for Payer: Aetna Commercial	$4,837.40
Rate for Payer: Aetna Medicare Advantage	$3,819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,246.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,246.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,246.15
Rate for Payer: Cigna Commercial	$6,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,080.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,800.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,909.50
Rate for Payer: UnitedHealthcare Community & State	$306.79
Rate for Payer: Wellpoint Medicaid Managed Care	$337.35

PLATE DISTAL FIBULA

Facility

$5,885.00

Hospital Charge Code	270702537
Hospital Revenue Code	278
Min. Negotiated Rate	$882.75
Max. Negotiated Rate	$1,424.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,424.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,294.70
Rate for Payer: Qualcare PPO/HMO/WC	$882.75

Know your out-of-pocket cost for care.

All Charges