Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE HUM DISTAL 6H RT 137MM

Facility

$4,993.45

Hospital Charge Code	270677631
Hospital Revenue Code	278
Min. Negotiated Rate	$120.34
Max. Negotiated Rate	$2,496.72
Rate for Payer: Aetna Commercial	$1,897.51
Rate for Payer: Aetna Medicare Advantage	$1,498.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.33
Rate for Payer: Cigna Commercial	$2,496.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.56
Rate for Payer: Qualcare PPO/HMO/WC	$749.02
Rate for Payer: UnitedHealthcare Community & State	$120.34
Rate for Payer: Wellpoint Medicaid Managed Care	$132.33

PLATE HUM DISTAL 6H RT 137MM

Facility

$4,993.45

Hospital Charge Code	270677631
Hospital Revenue Code	278
Min. Negotiated Rate	$749.02
Max. Negotiated Rate	$1,208.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.56
Rate for Payer: Qualcare PPO/HMO/WC	$749.02

PLATE HUM DISTAL 7H LT 127MM

Facility

$4,842.05

Hospital Charge Code	270677640
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

PLATE HUM DISTAL 7H LT 127MM

Facility

$4,842.05

Hospital Charge Code	270677640
Hospital Revenue Code	278
Min. Negotiated Rate	$116.69
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
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
Rate for Payer: UnitedHealthcare Community & State	$116.69
Rate for Payer: Wellpoint Medicaid Managed Care	$128.31

PLATE HUM DISTAL 7H LT 147MM

Facility

$4,842.05

Hospital Charge Code	270677670
Hospital Revenue Code	278
Min. Negotiated Rate	$116.69
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
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
Rate for Payer: UnitedHealthcare Community & State	$116.69
Rate for Payer: Wellpoint Medicaid Managed Care	$128.31

PLATE HUM DISTAL 7H LT 147MM

Facility

$4,842.05

Hospital Charge Code	270677670
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

PLATE HUM DISTAL 7H RT 127MM

Facility

$4,842.05

Hospital Charge Code	270677637
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

PLATE HUM DISTAL 7H RT 127MM

Facility

$4,842.05

Hospital Charge Code	270677637
Hospital Revenue Code	278
Min. Negotiated Rate	$116.69
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
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
Rate for Payer: UnitedHealthcare Community & State	$116.69
Rate for Payer: Wellpoint Medicaid Managed Care	$128.31

PLATE HUM DISTAL 7H RT 147MM

Facility

$4,842.05

Hospital Charge Code	270677666
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

PLATE HUM DISTAL 7H RT 147MM

Facility

$4,842.05

Hospital Charge Code	270677666
Hospital Revenue Code	278
Min. Negotiated Rate	$116.69
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
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
Rate for Payer: UnitedHealthcare Community & State	$116.69
Rate for Payer: Wellpoint Medicaid Managed Care	$128.31

PLATE HUM DISTAL 9H LT 153MM

Facility

$4,842.05

Hospital Charge Code	270677641
Hospital Revenue Code	278
Min. Negotiated Rate	$116.69
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
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
Rate for Payer: UnitedHealthcare Community & State	$116.69
Rate for Payer: Wellpoint Medicaid Managed Care	$128.31

PLATE HUM DISTAL 9H LT 153MM

Facility

$4,842.05

Hospital Charge Code	270677641
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

PLATE HUM DISTAL 9H RT 153MM

Facility

$4,842.05

Hospital Charge Code	270677638
Hospital Revenue Code	278
Min. Negotiated Rate	$116.69
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
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
Rate for Payer: UnitedHealthcare Community & State	$116.69
Rate for Payer: Wellpoint Medicaid Managed Care	$128.31

PLATE HUM DISTAL 9H RT 153MM

Facility

$4,842.05

Hospital Charge Code	270677638
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

PLATE HUM DISTAL RH RT 111MM

Facility

$4,993.45

Hospital Charge Code	270677630
Hospital Revenue Code	278
Min. Negotiated Rate	$749.02
Max. Negotiated Rate	$1,208.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.56
Rate for Payer: Qualcare PPO/HMO/WC	$749.02

PLATE HUM DISTAL RH RT 111MM

Facility

$4,993.45

Hospital Charge Code	270677630
Hospital Revenue Code	278
Min. Negotiated Rate	$120.34
Max. Negotiated Rate	$2,496.72
Rate for Payer: Aetna Commercial	$1,897.51
Rate for Payer: Aetna Medicare Advantage	$1,498.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.33
Rate for Payer: Cigna Commercial	$2,496.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.56
Rate for Payer: Qualcare PPO/HMO/WC	$749.02
Rate for Payer: UnitedHealthcare Community & State	$120.34
Rate for Payer: Wellpoint Medicaid Managed Care	$132.33

PLATE HUMERAL PROXIMAL R 4H 9m

Facility

$6,865.00

Hospital Charge Code	270669241
Hospital Revenue Code	278
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$3,432.50
Rate for Payer: Aetna Commercial	$2,608.70
Rate for Payer: Aetna Medicare Advantage	$2,059.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,750.58
Rate for Payer: Cigna Commercial	$3,432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,510.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75
Rate for Payer: UnitedHealthcare Community & State	$165.45
Rate for Payer: Wellpoint Medicaid Managed Care	$181.92

PLATE HUMERAL PROXIMAL R 4H 9m

Facility

$6,865.00

Hospital Charge Code	270669241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.75
Max. Negotiated Rate	$1,661.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,510.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75

PLATE HUM PROX HI RT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270697450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.25
Max. Negotiated Rate	$1,716.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25

PLATE HUM PROX HI RT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270697450
Hospital Revenue Code	278
Min. Negotiated Rate	$170.99
Max. Negotiated Rate	$3,547.50
Rate for Payer: Aetna Commercial	$2,696.10
Rate for Payer: Aetna Medicare Advantage	$2,128.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,809.22
Rate for Payer: Cigna Commercial	$3,547.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25
Rate for Payer: UnitedHealthcare Community & State	$170.99
Rate for Payer: Wellpoint Medicaid Managed Care	$188.02

PLATE HYBRID COMPRESS 4.5m 7H

Facility

$1,875.00

Hospital Charge Code	270671863
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

PLATE HYBRID COMPRESS 4.5m 7H

Facility

$1,875.00

Hospital Charge Code	270671863
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

PLATE INLINE 6MM

Facility

$9,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270680772
Hospital Revenue Code	278
Min. Negotiated Rate	$1,354.50
Max. Negotiated Rate	$2,185.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,806.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,185.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,986.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,354.50

PLATE INLINE 6MM

Facility

$9,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270680772
Hospital Revenue Code	278
Min. Negotiated Rate	$217.62
Max. Negotiated Rate	$4,515.00
Rate for Payer: Aetna Commercial	$3,431.40
Rate for Payer: Aetna Medicare Advantage	$2,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,302.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,302.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,302.65
Rate for Payer: Cigna Commercial	$4,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,185.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,986.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,354.50
Rate for Payer: UnitedHealthcare Community & State	$217.62
Rate for Payer: Wellpoint Medicaid Managed Care	$239.29

PLATE INTERBODIE 7MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677682
Hospital Revenue Code	278
Min. Negotiated Rate	$198.82
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$198.82
Rate for Payer: Wellpoint Medicaid Managed Care	$218.62

Know your out-of-pocket cost for care.

All Charges