Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LC-DCP TITN 3.5MM 18H

Facility

$1,940.00

Hospital Charge Code	270603358
Hospital Revenue Code	278
Min. Negotiated Rate	$46.75
Max. Negotiated Rate	$970.00
Rate for Payer: Aetna Commercial	$737.20
Rate for Payer: Aetna Medicare Advantage	$582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.70
Rate for Payer: Cigna Commercial	$970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$426.80
Rate for Payer: Qualcare PPO/HMO/WC	$291.00
Rate for Payer: UnitedHealthcare Community & State	$46.75
Rate for Payer: Wellpoint Medicaid Managed Care	$51.41

PLATE LC-DCP TITN 3.5MM 18H

Facility

$1,940.00

Hospital Charge Code	270603358
Hospital Revenue Code	278
Min. Negotiated Rate	$291.00
Max. Negotiated Rate	$469.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$426.80
Rate for Payer: Qualcare PPO/HMO/WC	$291.00

PLATE LC-DCP TITN 3.5MM 20H

Facility

$2,154.45

Hospital Charge Code	270603360
Hospital Revenue Code	278
Min. Negotiated Rate	$323.17
Max. Negotiated Rate	$521.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$430.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$473.98
Rate for Payer: Qualcare PPO/HMO/WC	$323.17

PLATE LC-DCP TITN 3.5MM 20H

Facility

$2,154.45

Hospital Charge Code	270603360
Hospital Revenue Code	278
Min. Negotiated Rate	$51.92
Max. Negotiated Rate	$1,077.22
Rate for Payer: Aetna Commercial	$818.69
Rate for Payer: Aetna Medicare Advantage	$646.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$549.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$549.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$430.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$549.38
Rate for Payer: Cigna Commercial	$1,077.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$473.98
Rate for Payer: Qualcare PPO/HMO/WC	$323.17
Rate for Payer: UnitedHealthcare Community & State	$51.92
Rate for Payer: Wellpoint Medicaid Managed Care	$57.09

PLATE LCP 10HOLE 3.5x137MM

Facility

$1,509.00

Hospital Charge Code	270677336
Hospital Revenue Code	278
Min. Negotiated Rate	$226.35
Max. Negotiated Rate	$365.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.98
Rate for Payer: Qualcare PPO/HMO/WC	$226.35

PLATE LCP 10HOLE 3.5x137MM

Facility

$1,509.00

Hospital Charge Code	270677336
Hospital Revenue Code	278
Min. Negotiated Rate	$36.37
Max. Negotiated Rate	$754.50
Rate for Payer: Aetna Commercial	$573.42
Rate for Payer: Aetna Medicare Advantage	$452.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.80
Rate for Payer: Cigna Commercial	$754.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.98
Rate for Payer: Qualcare PPO/HMO/WC	$226.35
Rate for Payer: UnitedHealthcare Community & State	$36.37
Rate for Payer: Wellpoint Medicaid Managed Care	$39.99

PLATE LCP 1/3 TUBULAR 4H 57MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270671206
Hospital Revenue Code	278
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$178.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$162.45
Rate for Payer: Qualcare PPO/HMO/WC	$110.76

PLATE LCP 1/3 TUBULAR 4H 57MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270671206
Hospital Revenue Code	278
Min. Negotiated Rate	$17.80
Max. Negotiated Rate	$369.20
Rate for Payer: Aetna Commercial	$280.59
Rate for Payer: Aetna Medicare Advantage	$221.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.29
Rate for Payer: Cigna Commercial	$369.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$162.45
Rate for Payer: Qualcare PPO/HMO/WC	$110.76
Rate for Payer: UnitedHealthcare Community & State	$17.80
Rate for Payer: Wellpoint Medicaid Managed Care	$19.57

PLATE LCP 1/3 TUBULAR 6H 69MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270648519
Hospital Revenue Code	278
Min. Negotiated Rate	$17.80
Max. Negotiated Rate	$369.20
Rate for Payer: Aetna Commercial	$280.59
Rate for Payer: Aetna Medicare Advantage	$221.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.29
Rate for Payer: Cigna Commercial	$369.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$162.45
Rate for Payer: Qualcare PPO/HMO/WC	$110.76
Rate for Payer: UnitedHealthcare Community & State	$17.80
Rate for Payer: Wellpoint Medicaid Managed Care	$19.57

PLATE LCP 1/3 TUBULAR 6H 69MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270648519
Hospital Revenue Code	278
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$178.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$162.45
Rate for Payer: Qualcare PPO/HMO/WC	$110.76

PLATE LCP 1/3 TUBULAR 7H 81MM

Facility

$754.30

Service Code	HCPCS C1713
Hospital Charge Code	270645152
Hospital Revenue Code	278
Min. Negotiated Rate	$18.18
Max. Negotiated Rate	$377.15
Rate for Payer: Aetna Commercial	$286.63
Rate for Payer: Aetna Medicare Advantage	$226.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.35
Rate for Payer: Cigna Commercial	$377.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.14
Rate for Payer: UnitedHealthcare Community & State	$18.18
Rate for Payer: Wellpoint Medicaid Managed Care	$19.99

PLATE LCP 1/3 TUBULAR 7H 81MM

Facility

$754.30

Service Code	HCPCS C1713
Hospital Charge Code	270645152
Hospital Revenue Code	278
Min. Negotiated Rate	$113.14
Max. Negotiated Rate	$182.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.14

PLATE LCP 1/3 TUBULAR 8H 93MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270637257
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$192.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULAR 8H 93MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270637257
Hospital Revenue Code	278
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$397.85
Rate for Payer: Aetna Commercial	$302.37
Rate for Payer: Aetna Medicare Advantage	$238.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.90
Rate for Payer: Cigna Commercial	$397.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$119.36
Rate for Payer: UnitedHealthcare Community & State	$19.18
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

PLATE LCP 1/3 TUBULR 10H 117MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270653166
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$192.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULR 10H 117MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270653166
Hospital Revenue Code	278
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$397.85
Rate for Payer: Aetna Commercial	$302.37
Rate for Payer: Aetna Medicare Advantage	$238.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.90
Rate for Payer: Cigna Commercial	$397.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$119.36
Rate for Payer: UnitedHealthcare Community & State	$19.18
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

PLATE LCP 1/3 TUBULR 12H 141MM

Facility

$797.20

Hospital Charge Code	270656708
Hospital Revenue Code	278
Min. Negotiated Rate	$19.21
Max. Negotiated Rate	$398.60
Rate for Payer: Aetna Commercial	$302.94
Rate for Payer: Aetna Medicare Advantage	$239.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.29
Rate for Payer: Cigna Commercial	$398.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.38
Rate for Payer: Qualcare PPO/HMO/WC	$119.58
Rate for Payer: UnitedHealthcare Community & State	$19.21
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

PLATE LCP 1/3 TUBULR 12H 141MM

Facility

$797.20

Hospital Charge Code	270656708
Hospital Revenue Code	278
Min. Negotiated Rate	$119.58
Max. Negotiated Rate	$192.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$175.38
Rate for Payer: Qualcare PPO/HMO/WC	$119.58

PLATE LCP 1.5MM 6HOLE W/GUIDES

Facility

$1,112.40

Service Code	HCPCS C1713
Hospital Charge Code	270666006
Hospital Revenue Code	278
Min. Negotiated Rate	$166.86
Max. Negotiated Rate	$269.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.73
Rate for Payer: Qualcare PPO/HMO/WC	$166.86

PLATE LCP 1.5MM 6HOLE W/GUIDES

Facility

$1,112.40

Service Code	HCPCS C1713
Hospital Charge Code	270666006
Hospital Revenue Code	278
Min. Negotiated Rate	$26.81
Max. Negotiated Rate	$556.20
Rate for Payer: Aetna Commercial	$422.71
Rate for Payer: Aetna Medicare Advantage	$333.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.66
Rate for Payer: Cigna Commercial	$556.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.73
Rate for Payer: Qualcare PPO/HMO/WC	$166.86
Rate for Payer: UnitedHealthcare Community & State	$26.81
Rate for Payer: Wellpoint Medicaid Managed Care	$29.48

PLATE LCP 2.0 6 HOLE

Facility

$1,515.80

Hospital Charge Code	270671710
Hospital Revenue Code	278
Min. Negotiated Rate	$227.37
Max. Negotiated Rate	$366.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$333.48
Rate for Payer: Qualcare PPO/HMO/WC	$227.37

PLATE LCP 2.0 6 HOLE

Facility

$1,515.80

Hospital Charge Code	270671710
Hospital Revenue Code	278
Min. Negotiated Rate	$36.53
Max. Negotiated Rate	$757.90
Rate for Payer: Aetna Commercial	$576.00
Rate for Payer: Aetna Medicare Advantage	$454.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.53
Rate for Payer: Cigna Commercial	$757.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$333.48
Rate for Payer: Qualcare PPO/HMO/WC	$227.37
Rate for Payer: UnitedHealthcare Community & State	$36.53
Rate for Payer: Wellpoint Medicaid Managed Care	$40.17

PLATE LCP 2.0x38MM 5HOLE

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270671287
Hospital Revenue Code	278
Min. Negotiated Rate	$25.10
Max. Negotiated Rate	$520.67
Rate for Payer: Aetna Commercial	$395.71
Rate for Payer: Aetna Medicare Advantage	$312.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.54
Rate for Payer: Cigna Commercial	$520.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$229.10
Rate for Payer: Qualcare PPO/HMO/WC	$156.20
Rate for Payer: UnitedHealthcare Community & State	$25.10
Rate for Payer: Wellpoint Medicaid Managed Care	$27.60

PLATE LCP 2.0x38MM 5HOLE

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270671287
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$252.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$229.10
Rate for Payer: Qualcare PPO/HMO/WC	$156.20

PLATE LCP 2.0x45MM 6HOLE

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270667131
Hospital Revenue Code	278
Min. Negotiated Rate	$25.85
Max. Negotiated Rate	$536.30
Rate for Payer: Aetna Commercial	$407.59
Rate for Payer: Aetna Medicare Advantage	$321.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.51
Rate for Payer: Cigna Commercial	$536.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.97
Rate for Payer: Qualcare PPO/HMO/WC	$160.89
Rate for Payer: UnitedHealthcare Community & State	$25.85
Rate for Payer: Wellpoint Medicaid Managed Care	$28.42

Know your out-of-pocket cost for care.

All Charges