Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FEMUR DISTAL 10H 238mm R

Facility

$11,871.00

Hospital Charge Code	270673781
Hospital Revenue Code	278
Min. Negotiated Rate	$286.09
Max. Negotiated Rate	$5,935.50
Rate for Payer: Aetna Commercial	$4,510.98
Rate for Payer: Aetna Medicare Advantage	$3,561.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,374.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,027.11
Rate for Payer: Cigna Commercial	$5,935.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,872.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,611.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,780.65
Rate for Payer: UnitedHealthcare Community & State	$286.09
Rate for Payer: Wellpoint Medicaid Managed Care	$314.58

PLATE FEMUR DISTAL 10H 238mm R

Facility

$11,871.00

Hospital Charge Code	270673781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,780.65
Max. Negotiated Rate	$2,872.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,374.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,872.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,611.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,780.65

PLATE FIB 3DI 89MM RT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$1,890.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,718.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

PLATE FIB 3DI 89MM RT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700377
Hospital Revenue Code	278
Min. Negotiated Rate	$188.28
Max. Negotiated Rate	$3,906.28
Rate for Payer: Aetna Commercial	$2,968.77
Rate for Payer: Aetna Medicare Advantage	$2,343.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,992.20
Rate for Payer: Cigna Commercial	$3,906.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,718.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88
Rate for Payer: UnitedHealthcare Community & State	$188.28
Rate for Payer: Wellpoint Medicaid Managed Care	$207.03

PLATE FIB LAT 3DI 77MM LT

Facility

$7,642.60

Service Code	HCPCS C1713
Hospital Charge Code	270700343
Hospital Revenue Code	278
Min. Negotiated Rate	$1,146.39
Max. Negotiated Rate	$1,849.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,528.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,849.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,681.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.39

PLATE FIB LAT 3DI 77MM LT

Facility

$7,642.60

Service Code	HCPCS C1713
Hospital Charge Code	270700343
Hospital Revenue Code	278
Min. Negotiated Rate	$184.19
Max. Negotiated Rate	$3,821.30
Rate for Payer: Aetna Commercial	$2,904.19
Rate for Payer: Aetna Medicare Advantage	$2,292.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,948.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,948.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,528.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,948.86
Rate for Payer: Cigna Commercial	$3,821.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,849.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,681.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.39
Rate for Payer: UnitedHealthcare Community & State	$184.19
Rate for Payer: Wellpoint Medicaid Managed Care	$202.53

PLATE FIB LAT 3DI 89MM LT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700379
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$1,890.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,718.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

PLATE FIB LAT 3DI 89MM LT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700379
Hospital Revenue Code	278
Min. Negotiated Rate	$188.28
Max. Negotiated Rate	$3,906.28
Rate for Payer: Aetna Commercial	$2,968.77
Rate for Payer: Aetna Medicare Advantage	$2,343.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,992.20
Rate for Payer: Cigna Commercial	$3,906.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,718.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88
Rate for Payer: UnitedHealthcare Community & State	$188.28
Rate for Payer: Wellpoint Medicaid Managed Care	$207.03

PLATE FIB PIT 13 HI ANTMCL RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270702043
Hospital Revenue Code	278
Min. Negotiated Rate	$165.36
Max. Negotiated Rate	$3,430.62
Rate for Payer: Aetna Commercial	$2,607.28
Rate for Payer: Aetna Medicare Advantage	$2,058.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,749.62
Rate for Payer: Cigna Commercial	$3,430.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,509.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19
Rate for Payer: UnitedHealthcare Community & State	$165.36
Rate for Payer: Wellpoint Medicaid Managed Care	$181.82

PLATE FIB PIT 13 HI ANTMCL RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270702043
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.19
Max. Negotiated Rate	$1,660.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,509.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

PLATE FIBULA 11 HOLE 2.7

Facility

$4,602.00

Hospital Charge Code	270664325
Hospital Revenue Code	278
Min. Negotiated Rate	$690.30
Max. Negotiated Rate	$1,113.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$920.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,113.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,012.44
Rate for Payer: Qualcare PPO/HMO/WC	$690.30

PLATE FIBULA 11 HOLE 2.7

Facility

$4,602.00

Hospital Charge Code	270664325
Hospital Revenue Code	278
Min. Negotiated Rate	$110.91
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$1,748.76
Rate for Payer: Aetna Medicare Advantage	$1,380.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,173.51
Rate for Payer: Cigna Commercial	$2,301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,113.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,012.44
Rate for Payer: Qualcare PPO/HMO/WC	$690.30
Rate for Payer: UnitedHealthcare Community & State	$110.91
Rate for Payer: Wellpoint Medicaid Managed Care	$121.95

PLATE FIBULA 4 HOLE 88MM

Facility

$3,303.30

Service Code	HCPCS C1713
Hospital Charge Code	270660367
Hospital Revenue Code	278
Min. Negotiated Rate	$79.61
Max. Negotiated Rate	$1,651.65
Rate for Payer: Aetna Commercial	$1,255.25
Rate for Payer: Aetna Medicare Advantage	$990.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$842.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$842.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$842.34
Rate for Payer: Cigna Commercial	$1,651.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.73
Rate for Payer: Qualcare PPO/HMO/WC	$495.50
Rate for Payer: UnitedHealthcare Community & State	$79.61
Rate for Payer: Wellpoint Medicaid Managed Care	$87.54

PLATE FIBULA 4 HOLE 88MM

Facility

$3,303.30

Service Code	HCPCS C1713
Hospital Charge Code	270660367
Hospital Revenue Code	278
Min. Negotiated Rate	$495.50
Max. Negotiated Rate	$799.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.73
Rate for Payer: Qualcare PPO/HMO/WC	$495.50

PLATE FIBULA 4 HOLE RIGHT 2.7/

Facility

$4,118.90

Service Code	HCPCS C1713
Hospital Charge Code	270668000
Hospital Revenue Code	278
Min. Negotiated Rate	$617.84
Max. Negotiated Rate	$996.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$906.16
Rate for Payer: Qualcare PPO/HMO/WC	$617.84

PLATE FIBULA 4 HOLE RIGHT 2.7/

Facility

$4,118.90

Service Code	HCPCS C1713
Hospital Charge Code	270668000
Hospital Revenue Code	278
Min. Negotiated Rate	$99.27
Max. Negotiated Rate	$2,059.45
Rate for Payer: Aetna Commercial	$1,565.18
Rate for Payer: Aetna Medicare Advantage	$1,235.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,050.32
Rate for Payer: Cigna Commercial	$2,059.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$906.16
Rate for Payer: Qualcare PPO/HMO/WC	$617.84
Rate for Payer: UnitedHealthcare Community & State	$99.27
Rate for Payer: Wellpoint Medicaid Managed Care	$109.15

PLATE FIBULA 5H LEFT

Facility

$2,679.05

Service Code	HCPCS C1713
Hospital Charge Code	270664044
Hospital Revenue Code	278
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$1,339.53
Rate for Payer: Aetna Commercial	$1,018.04
Rate for Payer: Aetna Medicare Advantage	$803.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.16
Rate for Payer: Cigna Commercial	$1,339.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.39
Rate for Payer: Qualcare PPO/HMO/WC	$401.86
Rate for Payer: UnitedHealthcare Community & State	$64.57
Rate for Payer: Wellpoint Medicaid Managed Care	$70.99

PLATE FIBULA 5H LEFT

Facility

$2,679.05

Service Code	HCPCS C1713
Hospital Charge Code	270664044
Hospital Revenue Code	278
Min. Negotiated Rate	$401.86
Max. Negotiated Rate	$648.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.39
Rate for Payer: Qualcare PPO/HMO/WC	$401.86

PLATE FIBULA 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691916
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE FIBULA 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691916
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$84.35
Rate for Payer: Wellpoint Medicaid Managed Care	$92.75

PLATE FIBULA 7 HOLE

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270668350
Hospital Revenue Code	278
Min. Negotiated Rate	$468.00
Max. Negotiated Rate	$755.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$686.40
Rate for Payer: Qualcare PPO/HMO/WC	$468.00

PLATE FIBULA 7 HOLE

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270668350
Hospital Revenue Code	278
Min. Negotiated Rate	$75.19
Max. Negotiated Rate	$1,560.00
Rate for Payer: Aetna Commercial	$1,185.60
Rate for Payer: Aetna Medicare Advantage	$936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$795.60
Rate for Payer: Cigna Commercial	$1,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$686.40
Rate for Payer: Qualcare PPO/HMO/WC	$468.00
Rate for Payer: UnitedHealthcare Community & State	$75.19
Rate for Payer: Wellpoint Medicaid Managed Care	$82.68

PLATE FIBULA 7-HOLE 814123007

Facility

$580.40

Hospital Charge Code	270632507
Hospital Revenue Code	278
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$220.55
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06
Rate for Payer: UnitedHealthcare Community & State	$13.99
Rate for Payer: Wellpoint Medicaid Managed Care	$15.38

PLATE FIBULA 7-HOLE 814123007

Facility

$580.40

Hospital Charge Code	270632507
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.69
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$4,326.00

Service Code	HCPCS C1713
Hospital Charge Code	270660713
Hospital Revenue Code	278
Min. Negotiated Rate	$648.90
Max. Negotiated Rate	$1,046.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$951.72
Rate for Payer: Qualcare PPO/HMO/WC	$648.90

Know your out-of-pocket cost for care.

All Charges