Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP 2.0x45MM 6HOLE

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270667131
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$259.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
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

PLATE LCP 2.0x52MM 7H

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270675499
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

PLATE LCP 2.0x52MM 7H

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270675499
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$259.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
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

PLATE LCP 2.4MM RAD HD 2H RT

Facility

$2,595.60

Service Code	HCPCS C1713
Hospital Charge Code	270675285
Hospital Revenue Code	278
Min. Negotiated Rate	$389.34
Max. Negotiated Rate	$628.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$571.03
Rate for Payer: Qualcare PPO/HMO/WC	$389.34

PLATE LCP 2.4MM RAD HD 2H RT

Facility

$2,595.60

Service Code	HCPCS C1713
Hospital Charge Code	270675285
Hospital Revenue Code	278
Min. Negotiated Rate	$62.55
Max. Negotiated Rate	$1,297.80
Rate for Payer: Aetna Commercial	$986.33
Rate for Payer: Aetna Medicare Advantage	$778.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.88
Rate for Payer: Cigna Commercial	$1,297.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$571.03
Rate for Payer: Qualcare PPO/HMO/WC	$389.34
Rate for Payer: UnitedHealthcare Community & State	$62.55
Rate for Payer: Wellpoint Medicaid Managed Care	$68.78

PLATE LCP 2.4x44MM 5HOLE

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270659768
Hospital Revenue Code	278
Min. Negotiated Rate	$249.82
Max. Negotiated Rate	$403.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$366.41
Rate for Payer: Qualcare PPO/HMO/WC	$249.82

PLATE LCP 2.4x44MM 5HOLE

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270659768
Hospital Revenue Code	278
Min. Negotiated Rate	$40.14
Max. Negotiated Rate	$832.75
Rate for Payer: Aetna Commercial	$632.89
Rate for Payer: Aetna Medicare Advantage	$499.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.70
Rate for Payer: Cigna Commercial	$832.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$366.41
Rate for Payer: Qualcare PPO/HMO/WC	$249.82
Rate for Payer: UnitedHealthcare Community & State	$40.14
Rate for Payer: Wellpoint Medicaid Managed Care	$44.14

PLATE LCP 2.73/3.5MM

Facility

$8,824.40

Service Code	HCPCS C1713
Hospital Charge Code	270688202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,323.66
Max. Negotiated Rate	$2,135.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,941.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.66

PLATE LCP 2.73/3.5MM

Facility

$8,824.40

Service Code	HCPCS C1713
Hospital Charge Code	270688202
Hospital Revenue Code	278
Min. Negotiated Rate	$212.67
Max. Negotiated Rate	$4,412.20
Rate for Payer: Aetna Commercial	$3,353.27
Rate for Payer: Aetna Medicare Advantage	$2,647.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,250.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,250.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,250.22
Rate for Payer: Cigna Commercial	$4,412.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,941.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.66
Rate for Payer: UnitedHealthcare Community & State	$212.67
Rate for Payer: Wellpoint Medicaid Managed Care	$233.85

PLATE LCP 2.7/3.5MM FIB 5H LFT

Facility

$2,688.00

Hospital Charge Code	270676814
Hospital Revenue Code	278
Min. Negotiated Rate	$64.78
Max. Negotiated Rate	$1,344.00
Rate for Payer: Aetna Commercial	$1,021.44
Rate for Payer: Aetna Medicare Advantage	$806.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.44
Rate for Payer: Cigna Commercial	$1,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$591.36
Rate for Payer: Qualcare PPO/HMO/WC	$403.20
Rate for Payer: UnitedHealthcare Community & State	$64.78
Rate for Payer: Wellpoint Medicaid Managed Care	$71.23

PLATE LCP 2.7/3.5MM FIB 5H LFT

Facility

$2,688.00

Hospital Charge Code	270676814
Hospital Revenue Code	278
Min. Negotiated Rate	$403.20
Max. Negotiated Rate	$650.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$591.36
Rate for Payer: Qualcare PPO/HMO/WC	$403.20

PLATE LCP 2.7x94MM 10HOLE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270675842
Hospital Revenue Code	278
Min. Negotiated Rate	$42.37
Max. Negotiated Rate	$879.10
Rate for Payer: Aetna Commercial	$668.12
Rate for Payer: Aetna Medicare Advantage	$527.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.34
Rate for Payer: Cigna Commercial	$879.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$386.80
Rate for Payer: Qualcare PPO/HMO/WC	$263.73
Rate for Payer: UnitedHealthcare Community & State	$42.37
Rate for Payer: Wellpoint Medicaid Managed Care	$46.59

PLATE LCP 2.7x94MM 10HOLE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270675842
Hospital Revenue Code	278
Min. Negotiated Rate	$263.73
Max. Negotiated Rate	$425.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$386.80
Rate for Payer: Qualcare PPO/HMO/WC	$263.73

PLATE LCP 2MM 8 HOLE

Facility

$1,011.00

Hospital Charge Code	270673372
Hospital Revenue Code	278
Min. Negotiated Rate	$24.37
Max. Negotiated Rate	$505.50
Rate for Payer: Aetna Commercial	$384.18
Rate for Payer: Aetna Medicare Advantage	$303.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.81
Rate for Payer: Cigna Commercial	$505.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$222.42
Rate for Payer: Qualcare PPO/HMO/WC	$151.65
Rate for Payer: UnitedHealthcare Community & State	$24.37
Rate for Payer: Wellpoint Medicaid Managed Care	$26.79

PLATE LCP 2MM 8 HOLE

Facility

$1,011.00

Hospital Charge Code	270673372
Hospital Revenue Code	278
Min. Negotiated Rate	$151.65
Max. Negotiated Rate	$244.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$222.42
Rate for Payer: Qualcare PPO/HMO/WC	$151.65

PLATE LCP 3.5 5 HOLE

Facility

$7,154.70

Service Code	HCPCS C1713
Hospital Charge Code	270684399
Hospital Revenue Code	278
Min. Negotiated Rate	$1,073.20
Max. Negotiated Rate	$1,731.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,574.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.20

PLATE LCP 3.5 5 HOLE

Facility

$7,154.70

Service Code	HCPCS C1713
Hospital Charge Code	270684399
Hospital Revenue Code	278
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$3,577.35
Rate for Payer: Aetna Commercial	$2,718.79
Rate for Payer: Aetna Medicare Advantage	$2,146.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,824.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,824.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,824.45
Rate for Payer: Cigna Commercial	$3,577.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,574.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.20
Rate for Payer: UnitedHealthcare Community & State	$172.43
Rate for Payer: Wellpoint Medicaid Managed Care	$189.60

PLATE LCP 3.5MM 12H 163MM

Facility

$1,771.80

Service Code	HCPCS C1713
Hospital Charge Code	270671054
Hospital Revenue Code	278
Min. Negotiated Rate	$42.70
Max. Negotiated Rate	$885.90
Rate for Payer: Aetna Commercial	$673.28
Rate for Payer: Aetna Medicare Advantage	$531.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.81
Rate for Payer: Cigna Commercial	$885.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$389.80
Rate for Payer: Qualcare PPO/HMO/WC	$265.77
Rate for Payer: UnitedHealthcare Community & State	$42.70
Rate for Payer: Wellpoint Medicaid Managed Care	$46.95

PLATE LCP 3.5MM 12H 163MM

Facility

$1,771.80

Service Code	HCPCS C1713
Hospital Charge Code	270671054
Hospital Revenue Code	278
Min. Negotiated Rate	$265.77
Max. Negotiated Rate	$428.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$389.80
Rate for Payer: Qualcare PPO/HMO/WC	$265.77

PLATE LCP 3.5MM 4H RT 122MM

Facility

$5,398.25

Service Code	HCPCS C1713
Hospital Charge Code	270679158
Hospital Revenue Code	278
Min. Negotiated Rate	$809.74
Max. Negotiated Rate	$1,306.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,187.62
Rate for Payer: Qualcare PPO/HMO/WC	$809.74

PLATE LCP 3.5MM 4H RT 122MM

Facility

$5,398.25

Service Code	HCPCS C1713
Hospital Charge Code	270679158
Hospital Revenue Code	278
Min. Negotiated Rate	$130.10
Max. Negotiated Rate	$2,699.12
Rate for Payer: Aetna Commercial	$2,051.34
Rate for Payer: Aetna Medicare Advantage	$1,619.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,376.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,376.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,376.55
Rate for Payer: Cigna Commercial	$2,699.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,187.62
Rate for Payer: Qualcare PPO/HMO/WC	$809.74
Rate for Payer: UnitedHealthcare Community & State	$130.10
Rate for Payer: Wellpoint Medicaid Managed Care	$143.05

PLATE LCP3.5MMPROXHUM3H109MMLT

Facility

$10,266.60

Service Code	HCPCS C1713
Hospital Charge Code	270698773
Hospital Revenue Code	278
Min. Negotiated Rate	$247.43
Max. Negotiated Rate	$5,133.30
Rate for Payer: Aetna Commercial	$3,901.31
Rate for Payer: Aetna Medicare Advantage	$3,079.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,617.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,617.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,053.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,617.98
Rate for Payer: Cigna Commercial	$5,133.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,484.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,258.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,539.99
Rate for Payer: UnitedHealthcare Community & State	$247.43
Rate for Payer: Wellpoint Medicaid Managed Care	$272.06

PLATE LCP3.5MMPROXHUM3H109MMLT

Facility

$10,266.60

Service Code	HCPCS C1713
Hospital Charge Code	270698773
Hospital Revenue Code	278
Min. Negotiated Rate	$1,539.99
Max. Negotiated Rate	$2,484.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,053.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,484.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,258.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,539.99

PLATE LCP 3.5x111MM 8HOLE

Facility

$1,492.70

Service Code	HCPCS C1713
Hospital Charge Code	270636273
Hospital Revenue Code	278
Min. Negotiated Rate	$35.97
Max. Negotiated Rate	$746.35
Rate for Payer: Aetna Commercial	$567.23
Rate for Payer: Aetna Medicare Advantage	$447.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.64
Rate for Payer: Cigna Commercial	$746.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.39
Rate for Payer: Qualcare PPO/HMO/WC	$223.91
Rate for Payer: UnitedHealthcare Community & State	$35.97
Rate for Payer: Wellpoint Medicaid Managed Care	$39.56

PLATE LCP 3.5x111MM 8HOLE

Facility

$1,492.70

Service Code	HCPCS C1713
Hospital Charge Code	270636273
Hospital Revenue Code	278
Min. Negotiated Rate	$223.91
Max. Negotiated Rate	$361.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$328.39
Rate for Payer: Qualcare PPO/HMO/WC	$223.91

Know your out-of-pocket cost for care.

All Charges