Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE HELIX R, 40MM 2 LEVEL

Facility

$8,545.00

Hospital Charge Code	270667692
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
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
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE HELIX R, 44MM 2-LEVEL

Facility

$8,545.00

Hospital Charge Code	270666087
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
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
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE HELIX R, 44MM 2-LEVEL

Facility

$8,545.00

Hospital Charge Code	270666087
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

PLATE HMD DISTAL 6H 5224-1006

Facility

$4,213.65

Hospital Charge Code	270620191
Hospital Revenue Code	278
Min. Negotiated Rate	$101.55
Max. Negotiated Rate	$2,106.82
Rate for Payer: Aetna Commercial	$1,601.19
Rate for Payer: Aetna Medicare Advantage	$1,264.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,074.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,074.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$842.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,074.48
Rate for Payer: Cigna Commercial	$2,106.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,019.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$927.00
Rate for Payer: Qualcare PPO/HMO/WC	$632.05
Rate for Payer: UnitedHealthcare Community & State	$101.55
Rate for Payer: Wellpoint Medicaid Managed Care	$111.66

PLATE HMD DISTAL 6H 5224-1006

Facility

$4,213.65

Hospital Charge Code	270620191
Hospital Revenue Code	278
Min. Negotiated Rate	$632.05
Max. Negotiated Rate	$1,019.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$842.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,019.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$927.00
Rate for Payer: Qualcare PPO/HMO/WC	$632.05

PLATE HOLDING TAC

Facility

$350.00

Hospital Charge Code	270669668
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

PLATE HOLDING TAC

Facility

$350.00

Hospital Charge Code	270669668
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PLATE HOLE 13 ANATOMIC LEFT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270701531
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 HOLE 13 ANATOMIC LEFT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270701531
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 HOOK 3 HOLE 3.5MM LCP

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270683790
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$575.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.05
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE HOOK 3 HOLE 3.5MM LCP

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270683790
Hospital Revenue Code	278
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$1,188.75
Rate for Payer: Aetna Commercial	$903.45
Rate for Payer: Aetna Medicare Advantage	$713.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.26
Rate for Payer: Cigna Commercial	$1,188.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.05
Rate for Payer: Qualcare PPO/HMO/WC	$356.62
Rate for Payer: UnitedHealthcare Community & State	$57.30
Rate for Payer: Wellpoint Medicaid Managed Care	$63.00

PLATE HOOK LG 3DI 70MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,130.17
Max. Negotiated Rate	$1,823.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,657.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17

PLATE HOOK LG 3DI 70MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700376
Hospital Revenue Code	278
Min. Negotiated Rate	$181.58
Max. Negotiated Rate	$3,767.22
Rate for Payer: Aetna Commercial	$2,863.09
Rate for Payer: Aetna Medicare Advantage	$2,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,921.28
Rate for Payer: Cigna Commercial	$3,767.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,657.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17
Rate for Payer: UnitedHealthcare Community & State	$181.58
Rate for Payer: Wellpoint Medicaid Managed Care	$199.66

PLATE HOOK LOCK TI 3 HOLE

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692862
Hospital Revenue Code	278
Min. Negotiated Rate	$111.46
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$111.46
Rate for Payer: Wellpoint Medicaid Managed Care	$122.56

PLATE HOOK LOCK TI 3 HOLE

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692862
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATE HOOK METARARSAL LONG RT

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695549
Hospital Revenue Code	278
Min. Negotiated Rate	$153.64
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$2,422.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,402.50
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Community & State	$153.64
Rate for Payer: Wellpoint Medicaid Managed Care	$168.94

PLATE HOOK METARARSAL LONG RT

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695549
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,402.50
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

PLATE HOOK SCREW CANN 4.0X36MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697015
Hospital Revenue Code	278
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

PLATE HOOK SCREW CANN 4.0X36MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697015
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

PLATE HOOK SM ORTLOC SYS

Facility

$6,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270701132
Hospital Revenue Code	278
Min. Negotiated Rate	$164.36
Max. Negotiated Rate	$3,410.00
Rate for Payer: Aetna Commercial	$2,591.60
Rate for Payer: Aetna Medicare Advantage	$2,046.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.10
Rate for Payer: Cigna Commercial	$3,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00
Rate for Payer: UnitedHealthcare Community & State	$164.36
Rate for Payer: Wellpoint Medicaid Managed Care	$180.73

PLATE HOOK SM ORTLOC SYS

Facility

$6,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270701132
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.00
Max. Negotiated Rate	$1,650.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00

PLATE HUM DISTAL 12 H 23480712

Facility

$1,992.50

Hospital Charge Code	270634818
Hospital Revenue Code	278
Min. Negotiated Rate	$48.02
Max. Negotiated Rate	$996.25
Rate for Payer: Aetna Commercial	$757.15
Rate for Payer: Aetna Medicare Advantage	$597.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.09
Rate for Payer: Cigna Commercial	$996.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.35
Rate for Payer: Qualcare PPO/HMO/WC	$298.88
Rate for Payer: UnitedHealthcare Community & State	$48.02
Rate for Payer: Wellpoint Medicaid Managed Care	$52.80

PLATE HUM DISTAL 12 H 23480712

Facility

$1,992.50

Hospital Charge Code	270634818
Hospital Revenue Code	278
Min. Negotiated Rate	$298.88
Max. Negotiated Rate	$482.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.35
Rate for Payer: Qualcare PPO/HMO/WC	$298.88

PLATE HUM DISTAL 1H LT 69MM

Facility

$5,049.05

Service Code	HCPCS C1713
Hospital Charge Code	270676865
Hospital Revenue Code	278
Min. Negotiated Rate	$757.36
Max. Negotiated Rate	$1,221.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,009.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,221.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,110.79
Rate for Payer: Qualcare PPO/HMO/WC	$757.36

PLATE HUM DISTAL 1H LT 69MM

Facility

$4,842.05

Hospital Charge Code	270677667
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$1,171.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,065.25
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

Know your out-of-pocket cost for care.

All Charges