Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP LAT 2.7/3.5 3H RT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270672038
Hospital Revenue Code	278
Min. Negotiated Rate	$62.63
Max. Negotiated Rate	$1,299.35
Rate for Payer: Aetna Commercial	$987.51
Rate for Payer: Aetna Medicare Advantage	$779.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$662.67
Rate for Payer: Cigna Commercial	$1,299.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$571.71
Rate for Payer: Qualcare PPO/HMO/WC	$389.81
Rate for Payer: UnitedHealthcare Community & State	$62.63
Rate for Payer: Wellpoint Medicaid Managed Care	$68.87

PLATE LCP LAT 2.7/3.5 3H RT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270672038
Hospital Revenue Code	278
Min. Negotiated Rate	$389.81
Max. Negotiated Rate	$628.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$571.71
Rate for Payer: Qualcare PPO/HMO/WC	$389.81

PLATE LCP LAT 2.7/3.5 4H LT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270653045
Hospital Revenue Code	278
Min. Negotiated Rate	$68.66
Max. Negotiated Rate	$1,424.50
Rate for Payer: Aetna Commercial	$1,082.62
Rate for Payer: Aetna Medicare Advantage	$854.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.50
Rate for Payer: Cigna Commercial	$1,424.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$626.78
Rate for Payer: Qualcare PPO/HMO/WC	$427.35
Rate for Payer: UnitedHealthcare Community & State	$68.66
Rate for Payer: Wellpoint Medicaid Managed Care	$75.50

PLATE LCP LAT 2.7/3.5 4H LT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270653045
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$689.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$626.78
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 4H RT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270646021
Hospital Revenue Code	278
Min. Negotiated Rate	$68.66
Max. Negotiated Rate	$1,424.50
Rate for Payer: Aetna Commercial	$1,082.62
Rate for Payer: Aetna Medicare Advantage	$854.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.50
Rate for Payer: Cigna Commercial	$1,424.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$626.78
Rate for Payer: Qualcare PPO/HMO/WC	$427.35
Rate for Payer: UnitedHealthcare Community & State	$68.66
Rate for Payer: Wellpoint Medicaid Managed Care	$75.50

PLATE LCP LAT 2.7/3.5 4H RT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270646021
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$689.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$626.78
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 5H LT ST

Facility

$2,886.05

Service Code	HCPCS C1713
Hospital Charge Code	270642838
Hospital Revenue Code	278
Min. Negotiated Rate	$69.55
Max. Negotiated Rate	$1,443.03
Rate for Payer: Aetna Commercial	$1,096.70
Rate for Payer: Aetna Medicare Advantage	$865.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.94
Rate for Payer: Cigna Commercial	$1,443.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$634.93
Rate for Payer: Qualcare PPO/HMO/WC	$432.91
Rate for Payer: UnitedHealthcare Community & State	$69.55
Rate for Payer: Wellpoint Medicaid Managed Care	$76.48

PLATE LCP LAT 2.7/3.5 5H LT ST

Facility

$2,886.05

Service Code	HCPCS C1713
Hospital Charge Code	270642838
Hospital Revenue Code	278
Min. Negotiated Rate	$432.91
Max. Negotiated Rate	$698.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$634.93
Rate for Payer: Qualcare PPO/HMO/WC	$432.91

PLATE LCP LAT 2.7/3.5 5H RT

Facility

$2,759.40

Service Code	HCPCS C1713
Hospital Charge Code	270642551
Hospital Revenue Code	278
Min. Negotiated Rate	$413.91
Max. Negotiated Rate	$667.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$607.07
Rate for Payer: Qualcare PPO/HMO/WC	$413.91

PLATE LCP LAT 2.7/3.5 5H RT

Facility

$2,759.40

Service Code	HCPCS C1713
Hospital Charge Code	270642551
Hospital Revenue Code	278
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$1,379.70
Rate for Payer: Aetna Commercial	$1,048.57
Rate for Payer: Aetna Medicare Advantage	$827.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$703.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$703.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$703.65
Rate for Payer: Cigna Commercial	$1,379.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$607.07
Rate for Payer: Qualcare PPO/HMO/WC	$413.91
Rate for Payer: UnitedHealthcare Community & State	$66.50
Rate for Payer: Wellpoint Medicaid Managed Care	$73.12

PLATE LCP LAT 2.7/3.5 6H LFT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270642839
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$1,400.40
Rate for Payer: Aetna Commercial	$1,064.30
Rate for Payer: Aetna Medicare Advantage	$840.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.20
Rate for Payer: Cigna Commercial	$1,400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.18
Rate for Payer: Qualcare PPO/HMO/WC	$420.12
Rate for Payer: UnitedHealthcare Community & State	$67.50
Rate for Payer: Wellpoint Medicaid Managed Care	$74.22

PLATE LCP LAT 2.7/3.5 6H LFT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270642839
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$677.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.18
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H LT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270646023
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$708.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.77
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 6H LT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270646023
Hospital Revenue Code	278
Min. Negotiated Rate	$70.52
Max. Negotiated Rate	$1,463.12
Rate for Payer: Aetna Commercial	$1,111.97
Rate for Payer: Aetna Medicare Advantage	$877.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.19
Rate for Payer: Cigna Commercial	$1,463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.77
Rate for Payer: Qualcare PPO/HMO/WC	$438.94
Rate for Payer: UnitedHealthcare Community & State	$70.52
Rate for Payer: Wellpoint Medicaid Managed Care	$77.55

PLATE LCP LAT 2.7/3.5 6H RT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270645183
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$677.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.18
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H RT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270645183
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$1,400.40
Rate for Payer: Aetna Commercial	$1,064.30
Rate for Payer: Aetna Medicare Advantage	$840.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.20
Rate for Payer: Cigna Commercial	$1,400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$616.18
Rate for Payer: Qualcare PPO/HMO/WC	$420.12
Rate for Payer: UnitedHealthcare Community & State	$67.50
Rate for Payer: Wellpoint Medicaid Managed Care	$74.22

PLATE LCP LAT 2.7/3.5 6H RT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270675622
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$708.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.77
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 6H RT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270675622
Hospital Revenue Code	278
Min. Negotiated Rate	$70.52
Max. Negotiated Rate	$1,463.12
Rate for Payer: Aetna Commercial	$1,111.97
Rate for Payer: Aetna Medicare Advantage	$877.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.19
Rate for Payer: Cigna Commercial	$1,463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.77
Rate for Payer: Qualcare PPO/HMO/WC	$438.94
Rate for Payer: UnitedHealthcare Community & State	$70.52
Rate for Payer: Wellpoint Medicaid Managed Care	$77.55

PLATE LCP LAT 2.7/3.5 7H LT ST

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644879
Hospital Revenue Code	278
Min. Negotiated Rate	$66.43
Max. Negotiated Rate	$1,378.15
Rate for Payer: Aetna Commercial	$1,047.39
Rate for Payer: Aetna Medicare Advantage	$826.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.86
Rate for Payer: Cigna Commercial	$1,378.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$606.39
Rate for Payer: Qualcare PPO/HMO/WC	$413.44
Rate for Payer: UnitedHealthcare Community & State	$66.43
Rate for Payer: Wellpoint Medicaid Managed Care	$73.04

PLATE LCP LAT 2.7/3.5 7H LT ST

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644879
Hospital Revenue Code	278
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$667.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$606.39
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

PLATE LCP LAT 2.7/3.5 7H RT

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644814
Hospital Revenue Code	278
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$667.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$606.39
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

PLATE LCP LAT 2.7/3.5 7H RT

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644814
Hospital Revenue Code	278
Min. Negotiated Rate	$66.43
Max. Negotiated Rate	$1,378.15
Rate for Payer: Aetna Commercial	$1,047.39
Rate for Payer: Aetna Medicare Advantage	$826.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.86
Rate for Payer: Cigna Commercial	$1,378.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$606.39
Rate for Payer: Qualcare PPO/HMO/WC	$413.44
Rate for Payer: UnitedHealthcare Community & State	$66.43
Rate for Payer: Wellpoint Medicaid Managed Care	$73.04

PLATE LCP LAT 2.7/3.5 9H RT ST

Facility

$3,099.25

Service Code	HCPCS C1713
Hospital Charge Code	270645138
Hospital Revenue Code	278
Min. Negotiated Rate	$464.89
Max. Negotiated Rate	$750.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$619.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$681.84
Rate for Payer: Qualcare PPO/HMO/WC	$464.89

PLATE LCP LAT 2.7/3.5 9H RT ST

Facility

$3,099.25

Service Code	HCPCS C1713
Hospital Charge Code	270645138
Hospital Revenue Code	278
Min. Negotiated Rate	$74.69
Max. Negotiated Rate	$1,549.62
Rate for Payer: Aetna Commercial	$1,177.71
Rate for Payer: Aetna Medicare Advantage	$929.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$619.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.31
Rate for Payer: Cigna Commercial	$1,549.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$681.84
Rate for Payer: Qualcare PPO/HMO/WC	$464.89
Rate for Payer: UnitedHealthcare Community & State	$74.69
Rate for Payer: Wellpoint Medicaid Managed Care	$82.13

PLATE LCP NARROW 10H 4.5x188MM

Facility

$2,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270637792
Hospital Revenue Code	278
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$560.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$509.85
Rate for Payer: Qualcare PPO/HMO/WC	$347.62

Know your out-of-pocket cost for care.

All Charges