Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$31,750.00

Hospital Charge Code	27060713
Hospital Revenue Code	278
Min. Negotiated Rate	$765.17
Max. Negotiated Rate	$15,875.00
Rate for Payer: Aetna Commercial	$12,065.00
Rate for Payer: Aetna Medicare Advantage	$9,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,096.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,096.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,096.25
Rate for Payer: Cigna Commercial	$15,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,683.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,985.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,762.50
Rate for Payer: UnitedHealthcare Community & State	$765.17
Rate for Payer: Wellpoint Medicaid Managed Care	$841.38

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$31,750.00

Hospital Charge Code	27060713
Hospital Revenue Code	278
Min. Negotiated Rate	$4,762.50
Max. Negotiated Rate	$7,683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,683.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,985.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,762.50

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	$104.26
Max. Negotiated Rate	$2,163.00
Rate for Payer: Aetna Commercial	$1,643.88
Rate for Payer: Aetna Medicare Advantage	$1,297.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.13
Rate for Payer: Cigna Commercial	$2,163.00
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
Rate for Payer: UnitedHealthcare Community & State	$104.26
Rate for Payer: Wellpoint Medicaid Managed Care	$114.64

PLATE FIBULA ANKLE FX 9H RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700268
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 ANKLE FX 9H RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700268
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 FIBULA DISTAL 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687751
Hospital Revenue Code	278
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

PLATE FIBULA DISTAL 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687751
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

PLATEFIBULALATLKG8H132MMRT

Facility

$4,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270695536
Hospital Revenue Code	278
Min. Negotiated Rate	$104.96
Max. Negotiated Rate	$2,177.50
Rate for Payer: Aetna Commercial	$1,654.90
Rate for Payer: Aetna Medicare Advantage	$1,306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,110.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,110.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$871.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,110.53
Rate for Payer: Cigna Commercial	$2,177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,053.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$958.10
Rate for Payer: Qualcare PPO/HMO/WC	$653.25
Rate for Payer: UnitedHealthcare Community & State	$104.96
Rate for Payer: Wellpoint Medicaid Managed Care	$115.41

PLATEFIBULALATLKG8H132MMRT

Facility

$4,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270695536
Hospital Revenue Code	278
Min. Negotiated Rate	$653.25
Max. Negotiated Rate	$1,053.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$871.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,053.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$958.10
Rate for Payer: Qualcare PPO/HMO/WC	$653.25

PLATE FIBULA LCP DISTAL RIGHT

Facility

$5,810.00

Hospital Charge Code	270666965
Hospital Revenue Code	278
Min. Negotiated Rate	$140.02
Max. Negotiated Rate	$2,905.00
Rate for Payer: Aetna Commercial	$2,207.80
Rate for Payer: Aetna Medicare Advantage	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,481.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,481.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,481.55
Rate for Payer: Cigna Commercial	$2,905.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,406.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,278.20
Rate for Payer: Qualcare PPO/HMO/WC	$871.50
Rate for Payer: UnitedHealthcare Community & State	$140.02
Rate for Payer: Wellpoint Medicaid Managed Care	$153.97

PLATE FIBULA LCP DISTAL RIGHT

Facility

$5,810.00

Hospital Charge Code	270666965
Hospital Revenue Code	278
Min. Negotiated Rate	$871.50
Max. Negotiated Rate	$1,406.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,406.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,278.20
Rate for Payer: Qualcare PPO/HMO/WC	$871.50

PLATE FIBULA LOCKING 4 HOLE

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691059
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

PLATE FIBULA LOCKING 4 HOLE

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691059
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

PLATE FIBULAR 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691919
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 FIBULAR 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691919
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 FIBULAR STR 9-HOLE

Facility

$3,437.50

Service Code	HCPCS C1713
Hospital Charge Code	270701514
Hospital Revenue Code	278
Min. Negotiated Rate	$515.62
Max. Negotiated Rate	$831.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$515.62

PLATE FIBULAR STR 9-HOLE

Facility

$3,437.50

Service Code	HCPCS C1713
Hospital Charge Code	270701514
Hospital Revenue Code	278
Min. Negotiated Rate	$82.84
Max. Negotiated Rate	$1,718.75
Rate for Payer: Aetna Commercial	$1,306.25
Rate for Payer: Aetna Medicare Advantage	$1,031.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$876.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$876.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$876.56
Rate for Payer: Cigna Commercial	$1,718.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$515.62
Rate for Payer: UnitedHealthcare Community & State	$82.84
Rate for Payer: Wellpoint Medicaid Managed Care	$91.09

PLATE FIBULA STR 10 HOLES

Facility

$3,500.00

Hospital Charge Code	270669980
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 STR 10 HOLES

Facility

$3,500.00

Hospital Charge Code	270669980
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 STR 8 HOLES 108MM

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270665783
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 STR 8 HOLES 108MM

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270665783
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 STRAIGHT 4H 60MM

Facility

$2,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270674889
Hospital Revenue Code	278
Min. Negotiated Rate	$58.32
Max. Negotiated Rate	$1,210.00
Rate for Payer: Aetna Commercial	$919.60
Rate for Payer: Aetna Medicare Advantage	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.10
Rate for Payer: Cigna Commercial	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.00
Rate for Payer: UnitedHealthcare Community & State	$58.32
Rate for Payer: Wellpoint Medicaid Managed Care	$64.13

PLATE FIBULA STRAIGHT 4H 60MM

Facility

$2,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270674889
Hospital Revenue Code	278
Min. Negotiated Rate	$363.00
Max. Negotiated Rate	$585.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.00

PLATE FIBULA TI 11H CLUSTER RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700402
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 FIBULA TI 11H CLUSTER RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700402
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

Know your out-of-pocket cost for care.

All Charges