Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP 3.5x124mm 9 HOLE

Facility

$1,464.00

Hospital Charge Code	270657239
Hospital Revenue Code	278
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$732.00
Rate for Payer: Aetna Commercial	$556.32
Rate for Payer: Aetna Medicare Advantage	$439.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.32
Rate for Payer: Cigna Commercial	$732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$322.08
Rate for Payer: Qualcare PPO/HMO/WC	$219.60
Rate for Payer: UnitedHealthcare Community & State	$35.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.80

PLATE LCP 3.5x124mm 9 HOLE

Facility

$1,464.00

Hospital Charge Code	270657239
Hospital Revenue Code	278
Min. Negotiated Rate	$219.60
Max. Negotiated Rate	$354.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$322.08
Rate for Payer: Qualcare PPO/HMO/WC	$219.60

PLATE LCP 3.5x190mm 14 HOLE

Facility

$5,325.00

Hospital Charge Code	270668238
Hospital Revenue Code	278
Min. Negotiated Rate	$128.33
Max. Negotiated Rate	$2,662.50
Rate for Payer: Aetna Commercial	$2,023.50
Rate for Payer: Aetna Medicare Advantage	$1,597.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,357.88
Rate for Payer: Cigna Commercial	$2,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,171.50
Rate for Payer: Qualcare PPO/HMO/WC	$798.75
Rate for Payer: UnitedHealthcare Community & State	$128.33
Rate for Payer: Wellpoint Medicaid Managed Care	$141.11

PLATE LCP 3.5x190mm 14 HOLE

Facility

$5,325.00

Hospital Charge Code	270668238
Hospital Revenue Code	278
Min. Negotiated Rate	$798.75
Max. Negotiated Rate	$1,288.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,171.50
Rate for Payer: Qualcare PPO/HMO/WC	$798.75

PLATE LCP 3.5x72MM 8HOLE

Facility

$1,245.25

Service Code	HCPCS C1713
Hospital Charge Code	270636274
Hospital Revenue Code	278
Min. Negotiated Rate	$186.79
Max. Negotiated Rate	$301.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.95
Rate for Payer: Qualcare PPO/HMO/WC	$186.79

PLATE LCP 3.5x72MM 8HOLE

Facility

$1,245.25

Service Code	HCPCS C1713
Hospital Charge Code	270636274
Hospital Revenue Code	278
Min. Negotiated Rate	$30.01
Max. Negotiated Rate	$622.62
Rate for Payer: Aetna Commercial	$473.19
Rate for Payer: Aetna Medicare Advantage	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.54
Rate for Payer: Cigna Commercial	$622.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.95
Rate for Payer: Qualcare PPO/HMO/WC	$186.79
Rate for Payer: UnitedHealthcare Community & State	$30.01
Rate for Payer: Wellpoint Medicaid Managed Care	$33.00

PLATE LCP 3.5x85MM 6HOLE

Facility

$1,365.35

Service Code	HCPCS C1713
Hospital Charge Code	270651089
Hospital Revenue Code	278
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$682.67
Rate for Payer: Aetna Commercial	$518.83
Rate for Payer: Aetna Medicare Advantage	$409.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.16
Rate for Payer: Cigna Commercial	$682.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.38
Rate for Payer: Qualcare PPO/HMO/WC	$204.80
Rate for Payer: UnitedHealthcare Community & State	$32.90
Rate for Payer: Wellpoint Medicaid Managed Care	$36.18

PLATE LCP 3.5x85MM 6HOLE

Facility

$1,365.35

Service Code	HCPCS C1713
Hospital Charge Code	270651089
Hospital Revenue Code	278
Min. Negotiated Rate	$204.80
Max. Negotiated Rate	$330.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.38
Rate for Payer: Qualcare PPO/HMO/WC	$204.80

PLATE LCP 3.5x98MM 7 HOLE

Facility

$1,378.15

Service Code	HCPCS C1713
Hospital Charge Code	270660908
Hospital Revenue Code	278
Min. Negotiated Rate	$206.72
Max. Negotiated Rate	$333.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.19
Rate for Payer: Qualcare PPO/HMO/WC	$206.72

PLATE LCP 3.5x98MM 7 HOLE

Facility

$1,378.15

Service Code	HCPCS C1713
Hospital Charge Code	270660908
Hospital Revenue Code	278
Min. Negotiated Rate	$33.21
Max. Negotiated Rate	$689.08
Rate for Payer: Aetna Commercial	$523.70
Rate for Payer: Aetna Medicare Advantage	$413.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.43
Rate for Payer: Cigna Commercial	$689.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.19
Rate for Payer: Qualcare PPO/HMO/WC	$206.72
Rate for Payer: UnitedHealthcare Community & State	$33.21
Rate for Payer: Wellpoint Medicaid Managed Care	$36.52

PLATE LCP 4.5x224mm 12HOLE NRW

Facility

$2,607.00

Service Code	HCPCS C1713
Hospital Charge Code	270666919
Hospital Revenue Code	278
Min. Negotiated Rate	$391.05
Max. Negotiated Rate	$630.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$521.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$630.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$573.54
Rate for Payer: Qualcare PPO/HMO/WC	$391.05

PLATE LCP 4.5x224mm 12HOLE NRW

Facility

$2,607.00

Service Code	HCPCS C1713
Hospital Charge Code	270666919
Hospital Revenue Code	278
Min. Negotiated Rate	$62.83
Max. Negotiated Rate	$1,303.50
Rate for Payer: Aetna Commercial	$990.66
Rate for Payer: Aetna Medicare Advantage	$782.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$664.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$664.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$521.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$664.78
Rate for Payer: Cigna Commercial	$1,303.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$630.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$573.54
Rate for Payer: Qualcare PPO/HMO/WC	$391.05
Rate for Payer: UnitedHealthcare Community & State	$62.83
Rate for Payer: Wellpoint Medicaid Managed Care	$69.09

PLATE LCP 4.5x282mm 15HOLE CRV

Facility

$3,751.25

Service Code	HCPCS C1713
Hospital Charge Code	270645542
Hospital Revenue Code	278
Min. Negotiated Rate	$562.69
Max. Negotiated Rate	$907.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.27
Rate for Payer: Qualcare PPO/HMO/WC	$562.69

PLATE LCP 4.5x282mm 15HOLE CRV

Facility

$3,751.25

Service Code	HCPCS C1713
Hospital Charge Code	270645542
Hospital Revenue Code	278
Min. Negotiated Rate	$90.41
Max. Negotiated Rate	$1,875.62
Rate for Payer: Aetna Commercial	$1,425.47
Rate for Payer: Aetna Medicare Advantage	$1,125.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.57
Rate for Payer: Cigna Commercial	$1,875.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.27
Rate for Payer: Qualcare PPO/HMO/WC	$562.69
Rate for Payer: UnitedHealthcare Community & State	$90.41
Rate for Payer: Wellpoint Medicaid Managed Care	$99.41

PLATE LCP 4 HOLES 2.4x36MM

Facility

$1,617.00

Service Code	HCPCS C1713
Hospital Charge Code	270659766
Hospital Revenue Code	278
Min. Negotiated Rate	$242.55
Max. Negotiated Rate	$391.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$355.74
Rate for Payer: Qualcare PPO/HMO/WC	$242.55

PLATE LCP 4 HOLES 2.4x36MM

Facility

$1,617.00

Service Code	HCPCS C1713
Hospital Charge Code	270659766
Hospital Revenue Code	278
Min. Negotiated Rate	$38.97
Max. Negotiated Rate	$808.50
Rate for Payer: Aetna Commercial	$614.46
Rate for Payer: Aetna Medicare Advantage	$485.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$412.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$412.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$412.33
Rate for Payer: Cigna Commercial	$808.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$355.74
Rate for Payer: Qualcare PPO/HMO/WC	$242.55
Rate for Payer: UnitedHealthcare Community & State	$38.97
Rate for Payer: Wellpoint Medicaid Managed Care	$42.85

PLATE LCP 4 HOLES 2.7x40MM

Facility

$1,707.00

Service Code	HCPCS C1713
Hospital Charge Code	270675319
Hospital Revenue Code	278
Min. Negotiated Rate	$256.05
Max. Negotiated Rate	$413.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$375.54
Rate for Payer: Qualcare PPO/HMO/WC	$256.05

PLATE LCP 4 HOLES 2.7x40MM

Facility

$1,707.00

Service Code	HCPCS C1713
Hospital Charge Code	270675319
Hospital Revenue Code	278
Min. Negotiated Rate	$41.14
Max. Negotiated Rate	$853.50
Rate for Payer: Aetna Commercial	$648.66
Rate for Payer: Aetna Medicare Advantage	$512.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.29
Rate for Payer: Cigna Commercial	$853.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$375.54
Rate for Payer: Qualcare PPO/HMO/WC	$256.05
Rate for Payer: UnitedHealthcare Community & State	$41.14
Rate for Payer: Wellpoint Medicaid Managed Care	$45.24

PLATE LCP 4 HOLES 2x31MM

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270674229
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 4 HOLES 2x31MM

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270674229
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 5 HOLES 2.7x49MM

Facility

$1,707.00

Service Code	HCPCS C1713
Hospital Charge Code	270673107
Hospital Revenue Code	278
Min. Negotiated Rate	$256.05
Max. Negotiated Rate	$413.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$375.54
Rate for Payer: Qualcare PPO/HMO/WC	$256.05

PLATE LCP 5 HOLES 2.7x49MM

Facility

$1,707.00

Service Code	HCPCS C1713
Hospital Charge Code	270673107
Hospital Revenue Code	278
Min. Negotiated Rate	$41.14
Max. Negotiated Rate	$853.50
Rate for Payer: Aetna Commercial	$648.66
Rate for Payer: Aetna Medicare Advantage	$512.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.29
Rate for Payer: Cigna Commercial	$853.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$375.54
Rate for Payer: Qualcare PPO/HMO/WC	$256.05
Rate for Payer: UnitedHealthcare Community & State	$41.14
Rate for Payer: Wellpoint Medicaid Managed Care	$45.24

PLATE LCP 6 HOLE 2.4x36MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270677804
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 6 HOLE 2.4x36MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270677804
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 6 HOLE 2.7x58MM

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270669793
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

Know your out-of-pocket cost for care.

All Charges