Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 7 HOLE 2.7X67MM

Facility

$5,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270700154
Hospital Revenue Code	278
Min. Negotiated Rate	$130.26
Max. Negotiated Rate	$2,702.50
Rate for Payer: Aetna Commercial	$2,053.90
Rate for Payer: Aetna Medicare Advantage	$1,621.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,378.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,378.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,081.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,378.28
Rate for Payer: Cigna Commercial	$2,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,189.10
Rate for Payer: Qualcare PPO/HMO/WC	$810.75
Rate for Payer: UnitedHealthcare Community & State	$130.26
Rate for Payer: Wellpoint Medicaid Managed Care	$143.23

PLATE LCP 7 HOLE 2.7X67MM

Facility

$5,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270700154
Hospital Revenue Code	278
Min. Negotiated Rate	$810.75
Max. Negotiated Rate	$1,308.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,081.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,189.10
Rate for Payer: Qualcare PPO/HMO/WC	$810.75

PLATE LCP 7 HOLE 7.5 MM

Facility

$1,872.00

Hospital Charge Code	270665748
Hospital Revenue Code	278
Min. Negotiated Rate	$280.80
Max. Negotiated Rate	$453.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$411.84
Rate for Payer: Qualcare PPO/HMO/WC	$280.80

PLATE LCP 7 HOLE 7.5 MM

Facility

$1,872.00

Hospital Charge Code	270665748
Hospital Revenue Code	278
Min. Negotiated Rate	$45.12
Max. Negotiated Rate	$936.00
Rate for Payer: Aetna Commercial	$711.36
Rate for Payer: Aetna Medicare Advantage	$561.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$477.36
Rate for Payer: Cigna Commercial	$936.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$411.84
Rate for Payer: Qualcare PPO/HMO/WC	$280.80
Rate for Payer: UnitedHealthcare Community & State	$45.12
Rate for Payer: Wellpoint Medicaid Managed Care	$49.61

PLATE LCP 7 HOLES 2.4x60MM

Facility

$1,617.00

Service Code	HCPCS C1713
Hospital Charge Code	270670415
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 7 HOLES 2.4x60MM

Facility

$1,617.00

Service Code	HCPCS C1713
Hospital Charge Code	270670415
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 9HOLE 4.5x170mm BRD

Facility

$2,424.00

Service Code	HCPCS C1713
Hospital Charge Code	270666771
Hospital Revenue Code	278
Min. Negotiated Rate	$363.60
Max. Negotiated Rate	$586.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$533.28
Rate for Payer: Qualcare PPO/HMO/WC	$363.60

PLATE LCP 9HOLE 4.5x170mm BRD

Facility

$2,424.00

Service Code	HCPCS C1713
Hospital Charge Code	270666771
Hospital Revenue Code	278
Min. Negotiated Rate	$58.42
Max. Negotiated Rate	$1,212.00
Rate for Payer: Aetna Commercial	$921.12
Rate for Payer: Aetna Medicare Advantage	$727.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.12
Rate for Payer: Cigna Commercial	$1,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$533.28
Rate for Payer: Qualcare PPO/HMO/WC	$363.60
Rate for Payer: UnitedHealthcare Community & State	$58.42
Rate for Payer: Wellpoint Medicaid Managed Care	$64.24

PLATE LCP ANT 6 HOLE 100MM

Facility

$4,532.15

Service Code	HCPCS C1713
Hospital Charge Code	270684726
Hospital Revenue Code	278
Min. Negotiated Rate	$109.22
Max. Negotiated Rate	$2,266.07
Rate for Payer: Aetna Commercial	$1,722.22
Rate for Payer: Aetna Medicare Advantage	$1,359.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,155.70
Rate for Payer: Cigna Commercial	$2,266.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$997.07
Rate for Payer: Qualcare PPO/HMO/WC	$679.82
Rate for Payer: UnitedHealthcare Community & State	$109.22
Rate for Payer: Wellpoint Medicaid Managed Care	$120.10

PLATE LCP ANT 6 HOLE 100MM

Facility

$4,532.15

Service Code	HCPCS C1713
Hospital Charge Code	270684726
Hospital Revenue Code	278
Min. Negotiated Rate	$679.82
Max. Negotiated Rate	$1,096.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$997.07
Rate for Payer: Qualcare PPO/HMO/WC	$679.82

PLATE LCP BRDCRVD 12H4.5x229MM

Facility

$3,241.40

Service Code	HCPCS C1713
Hospital Charge Code	270679265
Hospital Revenue Code	278
Min. Negotiated Rate	$78.12
Max. Negotiated Rate	$1,620.70
Rate for Payer: Aetna Commercial	$1,231.73
Rate for Payer: Aetna Medicare Advantage	$972.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$826.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$826.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$648.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$826.56
Rate for Payer: Cigna Commercial	$1,620.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$784.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$713.11
Rate for Payer: Qualcare PPO/HMO/WC	$486.21
Rate for Payer: UnitedHealthcare Community & State	$78.12
Rate for Payer: Wellpoint Medicaid Managed Care	$85.90

PLATE LCP BRDCRVD 12H4.5x229MM

Facility

$3,241.40

Service Code	HCPCS C1713
Hospital Charge Code	270679265
Hospital Revenue Code	278
Min. Negotiated Rate	$486.21
Max. Negotiated Rate	$784.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$648.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$784.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$713.11
Rate for Payer: Qualcare PPO/HMO/WC	$486.21

PLATE LCP BROAD 14H 4.5x247MM

Facility

$3,423.70

Service Code	HCPCS C1713
Hospital Charge Code	270678078
Hospital Revenue Code	278
Min. Negotiated Rate	$82.51
Max. Negotiated Rate	$1,711.85
Rate for Payer: Aetna Commercial	$1,301.01
Rate for Payer: Aetna Medicare Advantage	$1,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.04
Rate for Payer: Cigna Commercial	$1,711.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$753.21
Rate for Payer: Qualcare PPO/HMO/WC	$513.55
Rate for Payer: UnitedHealthcare Community & State	$82.51
Rate for Payer: Wellpoint Medicaid Managed Care	$90.73

PLATE LCP BROAD 14H 4.5x247MM

Facility

$3,423.70

Service Code	HCPCS C1713
Hospital Charge Code	270678078
Hospital Revenue Code	278
Min. Negotiated Rate	$513.55
Max. Negotiated Rate	$828.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$753.21
Rate for Payer: Qualcare PPO/HMO/WC	$513.55

PLATE LCP BROAD 9H 4.5x152MM

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270685043
Hospital Revenue Code	278
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$1,188.75
Rate for Payer: Aetna Commercial	$903.45
Rate for Payer: Aetna Medicare Advantage	$713.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.26
Rate for Payer: Cigna Commercial	$1,188.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.05
Rate for Payer: Qualcare PPO/HMO/WC	$356.62
Rate for Payer: UnitedHealthcare Community & State	$57.30
Rate for Payer: Wellpoint Medicaid Managed Care	$63.00

PLATE LCP BROAD 9H 4.5x152MM

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270685043
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$575.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.05
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE LCP CLAV 3.5x100MM 6H RT

Facility

$4,299.85

Service Code	HCPCS C1713
Hospital Charge Code	270688178
Hospital Revenue Code	278
Min. Negotiated Rate	$644.98
Max. Negotiated Rate	$1,040.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$859.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$945.97
Rate for Payer: Qualcare PPO/HMO/WC	$644.98

PLATE LCP CLAV 3.5x100MM 6H RT

Facility

$4,299.85

Service Code	HCPCS C1713
Hospital Charge Code	270688178
Hospital Revenue Code	278
Min. Negotiated Rate	$103.63
Max. Negotiated Rate	$2,149.93
Rate for Payer: Aetna Commercial	$1,633.94
Rate for Payer: Aetna Medicare Advantage	$1,289.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$859.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.46
Rate for Payer: Cigna Commercial	$2,149.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$945.97
Rate for Payer: Qualcare PPO/HMO/WC	$644.98
Rate for Payer: UnitedHealthcare Community & State	$103.63
Rate for Payer: Wellpoint Medicaid Managed Care	$113.95

PLATE LCP CLAV 3.5x100MM 7H LF

Facility

$3,942.85

Service Code	HCPCS C1713
Hospital Charge Code	270670741
Hospital Revenue Code	278
Min. Negotiated Rate	$591.43
Max. Negotiated Rate	$954.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$867.43
Rate for Payer: Qualcare PPO/HMO/WC	$591.43

PLATE LCP CLAV 3.5x100MM 7H LF

Facility

$3,942.85

Service Code	HCPCS C1713
Hospital Charge Code	270670741
Hospital Revenue Code	278
Min. Negotiated Rate	$95.02
Max. Negotiated Rate	$1,971.42
Rate for Payer: Aetna Commercial	$1,498.28
Rate for Payer: Aetna Medicare Advantage	$1,182.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,005.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,005.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,005.43
Rate for Payer: Cigna Commercial	$1,971.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$867.43
Rate for Payer: Qualcare PPO/HMO/WC	$591.43
Rate for Payer: UnitedHealthcare Community & State	$95.02
Rate for Payer: Wellpoint Medicaid Managed Care	$104.49

PLATE LCP CLAV 3.5x100MM 7H LT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270675952
Hospital Revenue Code	278
Min. Negotiated Rate	$100.01
Max. Negotiated Rate	$2,074.93
Rate for Payer: Aetna Commercial	$1,576.94
Rate for Payer: Aetna Medicare Advantage	$1,244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.21
Rate for Payer: Cigna Commercial	$2,074.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$912.97
Rate for Payer: Qualcare PPO/HMO/WC	$622.48
Rate for Payer: UnitedHealthcare Community & State	$100.01
Rate for Payer: Wellpoint Medicaid Managed Care	$109.97

PLATE LCP CLAV 3.5x100MM 7H LT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270675952
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$1,004.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$912.97
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x100MM 7H RT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270676235
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$1,004.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$912.97
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x100MM 7H RT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270676235
Hospital Revenue Code	278
Min. Negotiated Rate	$100.01
Max. Negotiated Rate	$2,074.93
Rate for Payer: Aetna Commercial	$1,576.94
Rate for Payer: Aetna Medicare Advantage	$1,244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.21
Rate for Payer: Cigna Commercial	$2,074.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$912.97
Rate for Payer: Qualcare PPO/HMO/WC	$622.48
Rate for Payer: UnitedHealthcare Community & State	$100.01
Rate for Payer: Wellpoint Medicaid Managed Care	$109.97

Know your out-of-pocket cost for care.

All Charges