Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LAPIDUS 4H MED WALL LT

Facility

$7,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270700173
Hospital Revenue Code	278
Min. Negotiated Rate	$171.98
Max. Negotiated Rate	$3,568.12
Rate for Payer: Aetna Commercial	$2,711.78
Rate for Payer: Aetna Medicare Advantage	$2,140.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,819.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,819.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,427.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,819.74
Rate for Payer: Cigna Commercial	$3,568.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,726.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,569.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,070.44
Rate for Payer: UnitedHealthcare Community & State	$171.98
Rate for Payer: Wellpoint Medicaid Managed Care	$189.11

PLATE LAPIDUS 4H MED WALL LT

Facility

$7,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270700173
Hospital Revenue Code	278
Min. Negotiated Rate	$1,070.44
Max. Negotiated Rate	$1,726.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,427.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,726.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,569.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,070.44

PLATE LAPIDUS CP 1MM LEFT

Facility

$6,771.25

Hospital Charge Code	270676860
Hospital Revenue Code	278
Min. Negotiated Rate	$1,015.69
Max. Negotiated Rate	$1,638.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,489.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.69

PLATE LAPIDUS CP 1MM LEFT

Facility

$6,771.25

Hospital Charge Code	270676860
Hospital Revenue Code	278
Min. Negotiated Rate	$163.19
Max. Negotiated Rate	$3,385.62
Rate for Payer: Aetna Commercial	$2,573.07
Rate for Payer: Aetna Medicare Advantage	$2,031.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,726.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,726.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,726.67
Rate for Payer: Cigna Commercial	$3,385.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,489.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.69
Rate for Payer: UnitedHealthcare Community & State	$163.19
Rate for Payer: Wellpoint Medicaid Managed Care	$179.44

PLATE LAPIDUS CROSSCHECK

Facility

$9,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270685334
Hospital Revenue Code	278
Min. Negotiated Rate	$237.75
Max. Negotiated Rate	$4,932.50
Rate for Payer: Aetna Commercial	$3,748.70
Rate for Payer: Aetna Medicare Advantage	$2,959.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,515.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,515.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,973.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,515.57
Rate for Payer: Cigna Commercial	$4,932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,387.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,170.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.75
Rate for Payer: UnitedHealthcare Community & State	$237.75
Rate for Payer: Wellpoint Medicaid Managed Care	$261.42

PLATE LAPIDUS CROSSCHECK

Facility

$9,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270685334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,479.75
Max. Negotiated Rate	$2,387.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,973.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,387.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,170.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.75

PLATE LAPIDUS FLAT

Facility

$7,680.00

Hospital Charge Code	270662453
Hospital Revenue Code	278
Min. Negotiated Rate	$185.09
Max. Negotiated Rate	$3,840.00
Rate for Payer: Aetna Commercial	$2,918.40
Rate for Payer: Aetna Medicare Advantage	$2,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,958.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,958.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,958.40
Rate for Payer: Cigna Commercial	$3,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,858.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,689.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.00
Rate for Payer: UnitedHealthcare Community & State	$185.09
Rate for Payer: Wellpoint Medicaid Managed Care	$203.52

PLATE LAPIDUS FLAT

Facility

$7,680.00

Hospital Charge Code	270662453
Hospital Revenue Code	278
Min. Negotiated Rate	$1,152.00
Max. Negotiated Rate	$1,858.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,536.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,858.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,689.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.00

PLATE LAPIDUS LONG

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679306
Hospital Revenue Code	278
Min. Negotiated Rate	$78.33
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$78.33
Rate for Payer: Wellpoint Medicaid Managed Care	$86.12

PLATE LAPIDUS LONG

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679306
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PLATE LAPIDUS STD LAPIFUSE5HRT

Facility

$12,985.00

Service Code	HCPCS C1713
Hospital Charge Code	270700665
Hospital Revenue Code	278
Min. Negotiated Rate	$312.94
Max. Negotiated Rate	$6,492.50
Rate for Payer: Aetna Commercial	$4,934.30
Rate for Payer: Aetna Medicare Advantage	$3,895.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,311.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,311.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,597.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,311.18
Rate for Payer: Cigna Commercial	$6,492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,142.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,856.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,947.75
Rate for Payer: UnitedHealthcare Community & State	$312.94
Rate for Payer: Wellpoint Medicaid Managed Care	$344.10

PLATE LAPIDUS STD LAPIFUSE5HRT

Facility

$12,985.00

Service Code	HCPCS C1713
Hospital Charge Code	270700665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,947.75
Max. Negotiated Rate	$3,142.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,597.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,142.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,856.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,947.75

PLATE LAPIDUS W/O STEP

Facility

$8,347.60

Hospital Charge Code	270667922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.14
Max. Negotiated Rate	$2,020.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,669.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,836.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.14

PLATE LAPIDUS W/O STEP

Facility

$8,347.60

Hospital Charge Code	270667922
Hospital Revenue Code	278
Min. Negotiated Rate	$201.18
Max. Negotiated Rate	$4,173.80
Rate for Payer: Aetna Commercial	$3,172.09
Rate for Payer: Aetna Medicare Advantage	$2,504.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,128.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,128.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,669.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,128.64
Rate for Payer: Cigna Commercial	$4,173.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,836.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.14
Rate for Payer: UnitedHealthcare Community & State	$201.18
Rate for Payer: Wellpoint Medicaid Managed Care	$221.21

PLATE LAPIPLASTY 28 SYST 4H

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696747
Hospital Revenue Code	278
Min. Negotiated Rate	$65.67
Max. Negotiated Rate	$1,362.50
Rate for Payer: Aetna Commercial	$1,035.50
Rate for Payer: Aetna Medicare Advantage	$817.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.88
Rate for Payer: Cigna Commercial	$1,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75
Rate for Payer: UnitedHealthcare Community & State	$65.67
Rate for Payer: Wellpoint Medicaid Managed Care	$72.21

PLATE LAPIPLASTY 28 SYST 4H

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696747
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$659.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.50
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

PLATE LARGE

Facility

$6,385.00

Hospital Charge Code	270661796
Hospital Revenue Code	272
Min. Negotiated Rate	$957.75
Max. Negotiated Rate	$957.75
Rate for Payer: Qualcare PPO/HMO/WC	$957.75

PLATE LARGE

Facility

$6,385.00

Hospital Charge Code	270661796
Hospital Revenue Code	272
Min. Negotiated Rate	$153.88
Max. Negotiated Rate	$3,192.50
Rate for Payer: Aetna Commercial	$2,426.30
Rate for Payer: Aetna Medicare Advantage	$1,915.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,628.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,628.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,628.17
Rate for Payer: Cigna Commercial	$3,192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.50
Rate for Payer: Oxford Commercial	$1,277.00
Rate for Payer: Qualcare PPO/HMO/WC	$957.75
Rate for Payer: UnitedHealthcare Commercial	$1,277.00
Rate for Payer: UnitedHealthcare Community & State	$153.88
Rate for Payer: Wellpoint Medicaid Managed Care	$169.20

PLATE LARGE 0 DEGREEE MTP

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270701523
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 LARGE 0 DEGREEE MTP

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270701523
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 LAT 10HOLE RIGHT LOCKING

Facility

$3,170.00

Hospital Charge Code	270638092
Hospital Revenue Code	278
Min. Negotiated Rate	$475.50
Max. Negotiated Rate	$767.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.40
Rate for Payer: Qualcare PPO/HMO/WC	$475.50

PLATE LAT 10HOLE RIGHT LOCKING

Facility

$3,170.00

Hospital Charge Code	270638092
Hospital Revenue Code	278
Min. Negotiated Rate	$76.40
Max. Negotiated Rate	$1,585.00
Rate for Payer: Aetna Commercial	$1,204.60
Rate for Payer: Aetna Medicare Advantage	$951.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$808.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$808.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$808.35
Rate for Payer: Cigna Commercial	$1,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.40
Rate for Payer: Qualcare PPO/HMO/WC	$475.50
Rate for Payer: UnitedHealthcare Community & State	$76.40
Rate for Payer: Wellpoint Medicaid Managed Care	$84.00

PLATE LAT 17.25X33.5MM 2HS Z14

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693847
Hospital Revenue Code	278
Min. Negotiated Rate	$481.40
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$529.34

PLATE LAT 17.25X33.5MM 2HS Z14

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693847
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

PLATE LAT 2H SZ12 17.25X31.5MM

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694488
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

Know your out-of-pocket cost for care.

All Charges