Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FRLOK COMP 8 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605260
Hospital Revenue Code	274
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$274.74
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45
Rate for Payer: UnitedHealthcare Community & State	$17.42
Rate for Payer: Wellpoint Medicaid Managed Care	$19.16

PLATE FRLOK COMP 8 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605260
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FUSION 1MPJ SM 7D LT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270694322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,359.75
Max. Negotiated Rate	$2,193.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,994.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75

PLATE FUSION 1MPJ SM 7D LT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270694322
Hospital Revenue Code	278
Min. Negotiated Rate	$218.47
Max. Negotiated Rate	$4,532.50
Rate for Payer: Aetna Commercial	$3,444.70
Rate for Payer: Aetna Medicare Advantage	$2,719.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,311.57
Rate for Payer: Cigna Commercial	$4,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,994.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75
Rate for Payer: UnitedHealthcare Community & State	$218.47
Rate for Payer: Wellpoint Medicaid Managed Care	$240.22

PLATE FUSION MIS HA COATED G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694466
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$9,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PLATE FUSION MIS HA COATED G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694466
Hospital Revenue Code	278
Min. Negotiated Rate	$964.00
Max. Negotiated Rate	$20,000.00
Rate for Payer: Aetna Commercial	$15,200.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Community & State	$964.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,060.00

PLATE FUSION VA-LCP 2.4/2.7MM

Facility

$3,909.00

Hospital Charge Code	270676909
Hospital Revenue Code	278
Min. Negotiated Rate	$94.21
Max. Negotiated Rate	$1,954.50
Rate for Payer: Aetna Commercial	$1,485.42
Rate for Payer: Aetna Medicare Advantage	$1,172.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$996.79
Rate for Payer: Cigna Commercial	$1,954.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$859.98
Rate for Payer: Qualcare PPO/HMO/WC	$586.35
Rate for Payer: UnitedHealthcare Community & State	$94.21
Rate for Payer: Wellpoint Medicaid Managed Care	$103.59

PLATE FUSION VA-LCP 2.4/2.7MM

Facility

$3,909.00

Hospital Charge Code	270676909
Hospital Revenue Code	278
Min. Negotiated Rate	$586.35
Max. Negotiated Rate	$945.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$859.98
Rate for Payer: Qualcare PPO/HMO/WC	$586.35

PLATE FUSION WRIST NEUTRAL

Facility

$11,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270691338
Hospital Revenue Code	278
Min. Negotiated Rate	$279.20
Max. Negotiated Rate	$5,792.50
Rate for Payer: Aetna Commercial	$4,402.30
Rate for Payer: Aetna Medicare Advantage	$3,475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,954.18
Rate for Payer: Cigna Commercial	$5,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,548.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75
Rate for Payer: UnitedHealthcare Community & State	$279.20
Rate for Payer: Wellpoint Medicaid Managed Care	$307.00

PLATE FUSION WRIST NEUTRAL

Facility

$11,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270691338
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.75
Max. Negotiated Rate	$2,803.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,548.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75

PLATE GEMINUS HOOK

Facility

$2,275.00

Hospital Charge Code	270664439
Hospital Revenue Code	278
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$550.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$500.50
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

PLATE GEMINUS HOOK

Facility

$2,275.00

Hospital Charge Code	270664439
Hospital Revenue Code	278
Min. Negotiated Rate	$54.83
Max. Negotiated Rate	$1,137.50
Rate for Payer: Aetna Commercial	$864.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$500.50
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Community & State	$54.83
Rate for Payer: Wellpoint Medicaid Managed Care	$60.29

PLATE GLENOID REVERSE SHOULDER

Facility

$7,952.40

Service Code	HCPCS C1713
Hospital Charge Code	270668552
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.86
Max. Negotiated Rate	$1,924.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,749.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.86

PLATE GLENOID REVERSE SHOULDER

Facility

$7,952.40

Service Code	HCPCS C1713
Hospital Charge Code	270668552
Hospital Revenue Code	278
Min. Negotiated Rate	$191.65
Max. Negotiated Rate	$3,976.20
Rate for Payer: Aetna Commercial	$3,021.91
Rate for Payer: Aetna Medicare Advantage	$2,385.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.86
Rate for Payer: Cigna Commercial	$3,976.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,749.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.86
Rate for Payer: UnitedHealthcare Community & State	$191.65
Rate for Payer: Wellpoint Medicaid Managed Care	$210.74

PLATE GORILLA MTP MED RT 5D

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270700642
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$1,573.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.83
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

PLATE GORILLA MTP MED RT 5D

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270700642
Hospital Revenue Code	278
Min. Negotiated Rate	$156.74
Max. Negotiated Rate	$3,251.88
Rate for Payer: Aetna Commercial	$2,471.43
Rate for Payer: Aetna Medicare Advantage	$1,951.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,658.46
Rate for Payer: Cigna Commercial	$3,251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.83
Rate for Payer: Qualcare PPO/HMO/WC	$975.56
Rate for Payer: UnitedHealthcare Community & State	$156.74
Rate for Payer: Wellpoint Medicaid Managed Care	$172.35

PLATE GRIDLOCK VLC 2HOLE

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680717
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

PLATE GRIDLOCK VLC 2HOLE

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680717
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE GRIP THROC. MED 200MM

Facility

$13,012.00

Hospital Charge Code	270670738
Hospital Revenue Code	272
Min. Negotiated Rate	$313.59
Max. Negotiated Rate	$6,506.00
Rate for Payer: Aetna Commercial	$4,944.56
Rate for Payer: Aetna Medicare Advantage	$3,903.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,318.06
Rate for Payer: Cigna Commercial	$6,506.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,903.60
Rate for Payer: Oxford Commercial	$2,602.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80
Rate for Payer: UnitedHealthcare Commercial	$2,602.40
Rate for Payer: UnitedHealthcare Community & State	$313.59
Rate for Payer: Wellpoint Medicaid Managed Care	$344.82

PLATE GRIP THROC. MED 200MM

Facility

$13,012.00

Hospital Charge Code	270670738
Hospital Revenue Code	272
Min. Negotiated Rate	$1,951.80
Max. Negotiated Rate	$1,951.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80

PLATE GRUVE 20MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699044
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

PLATE GRUVE 20MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699044
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE HA REMOVABLE END 12

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692076
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$9,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PLATE HA REMOVABLE END 12

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692076
Hospital Revenue Code	278
Min. Negotiated Rate	$964.00
Max. Negotiated Rate	$20,000.00
Rate for Payer: Aetna Commercial	$15,200.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Community & State	$964.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,060.00

PLATE HELIX R, 40MM 2 LEVEL

Facility

$8,545.00

Hospital Charge Code	270667692
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

Know your out-of-pocket cost for care.

All Charges