Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DISTAL FIBULA SS LFT 12H

Facility

$4,300.00

Hospital Charge Code	270671890
Hospital Revenue Code	278
Min. Negotiated Rate	$645.00
Max. Negotiated Rate	$1,040.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$946.00
Rate for Payer: Qualcare PPO/HMO/WC	$645.00

PLATE DISTAL FIBULA SS LFT 12H

Facility

$4,300.00

Hospital Charge Code	270671890
Hospital Revenue Code	278
Min. Negotiated Rate	$103.63
Max. Negotiated Rate	$2,150.00
Rate for Payer: Aetna Commercial	$1,634.00
Rate for Payer: Aetna Medicare Advantage	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.50
Rate for Payer: Cigna Commercial	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$946.00
Rate for Payer: Qualcare PPO/HMO/WC	$645.00
Rate for Payer: UnitedHealthcare Community & State	$103.63
Rate for Payer: Wellpoint Medicaid Managed Care	$113.95

PLATE DISTAL FIBULA SS LFT 14H

Facility

$4,350.00

Hospital Charge Code	270671891
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$104.83
Rate for Payer: Wellpoint Medicaid Managed Care	$115.28

PLATE DISTAL FIBULA SS LFT 14H

Facility

$4,350.00

Hospital Charge Code	270671891
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

PLATE DISTAL FIBULA SS RT 10H

Facility

$4,250.00

Hospital Charge Code	270671892
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 DISTAL FIBULA SS RT 10H

Facility

$4,250.00

Hospital Charge Code	270671892
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 DISTAL FIBULA SS RT 12H

Facility

$4,300.00

Hospital Charge Code	270671893
Hospital Revenue Code	278
Min. Negotiated Rate	$103.63
Max. Negotiated Rate	$2,150.00
Rate for Payer: Aetna Commercial	$1,634.00
Rate for Payer: Aetna Medicare Advantage	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.50
Rate for Payer: Cigna Commercial	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$946.00
Rate for Payer: Qualcare PPO/HMO/WC	$645.00
Rate for Payer: UnitedHealthcare Community & State	$103.63
Rate for Payer: Wellpoint Medicaid Managed Care	$113.95

PLATE DISTAL FIBULA SS RT 12H

Facility

$4,300.00

Hospital Charge Code	270671893
Hospital Revenue Code	278
Min. Negotiated Rate	$645.00
Max. Negotiated Rate	$1,040.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$946.00
Rate for Payer: Qualcare PPO/HMO/WC	$645.00

PLATE DISTAL FIBULA SS RT 14H

Facility

$4,350.00

Hospital Charge Code	270671894
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

PLATE DISTAL FIBULA SS RT 14H

Facility

$4,350.00

Hospital Charge Code	270671894
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$957.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$104.83
Rate for Payer: Wellpoint Medicaid Managed Care	$115.28

PLATE DISTAL FIBULA SS RT 4H

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659872
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 FIBULA SS RT 4H

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659872
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 FIBULA SS RT 5H

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270665697
Hospital Revenue Code	278
Min. Negotiated Rate	$78.33
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$78.33
Rate for Payer: Wellpoint Medicaid Managed Care	$86.12

PLATE DISTAL FIBULA SS RT 5H

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270665697
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PLATE DISTAL FIBULA SS RT 8H

Facility

$3,975.00

Hospital Charge Code	270670522
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE DISTAL FIBULA SS RT 8H

Facility

$3,975.00

Hospital Charge Code	270670522
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

PLATE DISTAL LATERAL 2.7m 5H L

Facility

$3,648.00

Hospital Charge Code	270674027
Hospital Revenue Code	272
Min. Negotiated Rate	$547.20
Max. Negotiated Rate	$547.20
Rate for Payer: Qualcare PPO/HMO/WC	$547.20

PLATE DISTAL LATERAL 2.7m 5H L

Facility

$3,648.00

Hospital Charge Code	270674027
Hospital Revenue Code	272
Min. Negotiated Rate	$87.92
Max. Negotiated Rate	$1,824.00
Rate for Payer: Aetna Commercial	$1,386.24
Rate for Payer: Aetna Medicare Advantage	$1,094.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.24
Rate for Payer: Cigna Commercial	$1,824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,094.40
Rate for Payer: Oxford Commercial	$729.60
Rate for Payer: Qualcare PPO/HMO/WC	$547.20
Rate for Payer: UnitedHealthcare Commercial	$729.60
Rate for Payer: UnitedHealthcare Community & State	$87.92
Rate for Payer: Wellpoint Medicaid Managed Care	$96.67

PLATE DISTAL LATERAL 5H 2.7mm

Facility

$4,083.40

Service Code	HCPCS C1713
Hospital Charge Code	270661556
Hospital Revenue Code	278
Min. Negotiated Rate	$612.51
Max. Negotiated Rate	$988.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$898.35
Rate for Payer: Qualcare PPO/HMO/WC	$612.51

PLATE DISTAL LATERAL 5H 2.7mm

Facility

$4,083.40

Service Code	HCPCS C1713
Hospital Charge Code	270661556
Hospital Revenue Code	278
Min. Negotiated Rate	$98.41
Max. Negotiated Rate	$2,041.70
Rate for Payer: Aetna Commercial	$1,551.69
Rate for Payer: Aetna Medicare Advantage	$1,225.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,041.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,041.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,041.27
Rate for Payer: Cigna Commercial	$2,041.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$898.35
Rate for Payer: Qualcare PPO/HMO/WC	$612.51
Rate for Payer: UnitedHealthcare Community & State	$98.41
Rate for Payer: Wellpoint Medicaid Managed Care	$108.21

PLATE DISTAL LAT FIB 234701804

Facility

$1,676.50

Hospital Charge Code	270630827
Hospital Revenue Code	278
Min. Negotiated Rate	$40.40
Max. Negotiated Rate	$838.25
Rate for Payer: Aetna Commercial	$637.07
Rate for Payer: Aetna Medicare Advantage	$502.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.51
Rate for Payer: Cigna Commercial	$838.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$368.83
Rate for Payer: Qualcare PPO/HMO/WC	$251.47
Rate for Payer: UnitedHealthcare Community & State	$40.40
Rate for Payer: Wellpoint Medicaid Managed Care	$44.43

PLATE DISTAL LAT FIB 234701804

Facility

$1,676.50

Hospital Charge Code	270630827
Hospital Revenue Code	278
Min. Negotiated Rate	$251.47
Max. Negotiated Rate	$405.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$368.83
Rate for Payer: Qualcare PPO/HMO/WC	$251.47

PLATE DISTAL NARROW 6 X 7 MM R

Facility

$23,995.00

Service Code	HCPCS C1713
Hospital Charge Code	270700835
Hospital Revenue Code	278
Min. Negotiated Rate	$578.28
Max. Negotiated Rate	$11,997.50
Rate for Payer: Aetna Commercial	$9,118.10
Rate for Payer: Aetna Medicare Advantage	$7,198.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,118.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,118.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,799.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,118.73
Rate for Payer: Cigna Commercial	$11,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,806.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,278.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,599.25
Rate for Payer: UnitedHealthcare Community & State	$578.28
Rate for Payer: Wellpoint Medicaid Managed Care	$635.87

PLATE DISTAL NARROW 6 X 7 MM R

Facility

$23,995.00

Service Code	HCPCS C1713
Hospital Charge Code	270700835
Hospital Revenue Code	278
Min. Negotiated Rate	$3,599.25
Max. Negotiated Rate	$5,806.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,799.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,806.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,278.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,599.25

PLATE DISTAL RADIUS 4 HOLE

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664366
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

Know your out-of-pocket cost for care.

All Charges