Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE L-FUSION 2.4/2.7MM SH RT

Facility

$3,828.00

Service Code	HCPCS C1713
Hospital Charge Code	270675598
Hospital Revenue Code	278
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$1,914.00
Rate for Payer: Aetna Commercial	$1,454.64
Rate for Payer: Aetna Medicare Advantage	$1,148.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$976.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$976.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$976.14
Rate for Payer: Cigna Commercial	$1,914.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$926.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$842.16
Rate for Payer: Qualcare PPO/HMO/WC	$574.20
Rate for Payer: UnitedHealthcare Community & State	$92.25
Rate for Payer: Wellpoint Medicaid Managed Care	$101.44

PLATE LG ANTER TIBIA 2DI SYS

Facility

$5,611.50

Service Code	HCPCS C1713
Hospital Charge Code	270704105
Hospital Revenue Code	278
Min. Negotiated Rate	$135.24
Max. Negotiated Rate	$2,805.75
Rate for Payer: Aetna Commercial	$2,132.37
Rate for Payer: Aetna Medicare Advantage	$1,683.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,430.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,430.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,430.93
Rate for Payer: Cigna Commercial	$2,805.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.53
Rate for Payer: Qualcare PPO/HMO/WC	$841.73
Rate for Payer: UnitedHealthcare Community & State	$135.24
Rate for Payer: Wellpoint Medicaid Managed Care	$148.70

PLATE LG ANTER TIBIA 2DI SYS

Facility

$5,611.50

Service Code	HCPCS C1713
Hospital Charge Code	270704105
Hospital Revenue Code	278
Min. Negotiated Rate	$841.73
Max. Negotiated Rate	$1,357.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.53
Rate for Payer: Qualcare PPO/HMO/WC	$841.73

PLATE LG FRAGMENT 4HOLE 143614

Facility

$947.45

Hospital Charge Code	270633175
Hospital Revenue Code	278
Min. Negotiated Rate	$22.83
Max. Negotiated Rate	$473.73
Rate for Payer: Aetna Commercial	$360.03
Rate for Payer: Aetna Medicare Advantage	$284.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.60
Rate for Payer: Cigna Commercial	$473.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$208.44
Rate for Payer: Qualcare PPO/HMO/WC	$142.12
Rate for Payer: UnitedHealthcare Community & State	$22.83
Rate for Payer: Wellpoint Medicaid Managed Care	$25.11

PLATE LG FRAGMENT 4HOLE 143614

Facility

$947.45

Hospital Charge Code	270633175
Hospital Revenue Code	278
Min. Negotiated Rate	$142.12
Max. Negotiated Rate	$229.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$208.44
Rate for Payer: Qualcare PPO/HMO/WC	$142.12

PLATE LG FRAGMENT 6HOLE 143616

Facility

$1,076.40

Hospital Charge Code	270633167
Hospital Revenue Code	278
Min. Negotiated Rate	$25.94
Max. Negotiated Rate	$538.20
Rate for Payer: Aetna Commercial	$409.03
Rate for Payer: Aetna Medicare Advantage	$322.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.48
Rate for Payer: Cigna Commercial	$538.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.81
Rate for Payer: Qualcare PPO/HMO/WC	$161.46
Rate for Payer: UnitedHealthcare Community & State	$25.94
Rate for Payer: Wellpoint Medicaid Managed Care	$28.52

PLATE LG FRAGMENT 6HOLE 143616

Facility

$1,076.40

Hospital Charge Code	270633167
Hospital Revenue Code	278
Min. Negotiated Rate	$161.46
Max. Negotiated Rate	$260.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.81
Rate for Payer: Qualcare PPO/HMO/WC	$161.46

PLATE LISFRANC MEDIUM

Facility

$10,015.00

Hospital Charge Code	270669553
Hospital Revenue Code	278
Min. Negotiated Rate	$241.36
Max. Negotiated Rate	$5,007.50
Rate for Payer: Aetna Commercial	$3,805.70
Rate for Payer: Aetna Medicare Advantage	$3,004.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,553.82
Rate for Payer: Cigna Commercial	$5,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,203.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25
Rate for Payer: UnitedHealthcare Community & State	$241.36
Rate for Payer: Wellpoint Medicaid Managed Care	$265.40

PLATE LISFRANC MEDIUM

Facility

$10,015.00

Hospital Charge Code	270669553
Hospital Revenue Code	278
Min. Negotiated Rate	$1,502.25
Max. Negotiated Rate	$2,423.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,203.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25

PLATE LISS RIGHT 13 HOLE FEMUR

Facility

$6,804.00

Hospital Charge Code	270669725
Hospital Revenue Code	278
Min. Negotiated Rate	$163.98
Max. Negotiated Rate	$3,402.00
Rate for Payer: Aetna Commercial	$2,585.52
Rate for Payer: Aetna Medicare Advantage	$2,041.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.02
Rate for Payer: Cigna Commercial	$3,402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,496.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60
Rate for Payer: UnitedHealthcare Community & State	$163.98
Rate for Payer: Wellpoint Medicaid Managed Care	$180.31

PLATE LISS RIGHT 13 HOLE FEMUR

Facility

$6,804.00

Hospital Charge Code	270669725
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$1,646.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,496.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE LK ANT CALCA 2.7X56MML

Facility

$4,492.00

Service Code	HCPCS C1713
Hospital Charge Code	270693304
Hospital Revenue Code	278
Min. Negotiated Rate	$108.26
Max. Negotiated Rate	$2,246.00
Rate for Payer: Aetna Commercial	$1,706.96
Rate for Payer: Aetna Medicare Advantage	$1,347.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$898.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,145.46
Rate for Payer: Cigna Commercial	$2,246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$988.24
Rate for Payer: Qualcare PPO/HMO/WC	$673.80
Rate for Payer: UnitedHealthcare Community & State	$108.26
Rate for Payer: Wellpoint Medicaid Managed Care	$119.04

PLATE LK ANT CALCA 2.7X56MML

Facility

$4,492.00

Service Code	HCPCS C1713
Hospital Charge Code	270693304
Hospital Revenue Code	278
Min. Negotiated Rate	$673.80
Max. Negotiated Rate	$1,087.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$898.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$988.24
Rate for Payer: Qualcare PPO/HMO/WC	$673.80

PLATE LKG PAT SS 3H SM 2.7 VA

Facility

$10,419.75

Service Code	HCPCS C1713
Hospital Charge Code	270694962
Hospital Revenue Code	278
Min. Negotiated Rate	$251.12
Max. Negotiated Rate	$5,209.88
Rate for Payer: Aetna Commercial	$3,959.51
Rate for Payer: Aetna Medicare Advantage	$3,125.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,657.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,657.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,083.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,657.04
Rate for Payer: Cigna Commercial	$5,209.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,521.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,292.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,562.96
Rate for Payer: UnitedHealthcare Community & State	$251.12
Rate for Payer: Wellpoint Medicaid Managed Care	$276.12

PLATE LKG PAT SS 3H SM 2.7 VA

Facility

$10,419.75

Service Code	HCPCS C1713
Hospital Charge Code	270694962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,562.96
Max. Negotiated Rate	$2,521.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,083.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,521.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,292.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,562.96

PLATE LKG SPINAL LP PROLINK

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698824
Hospital Revenue Code	278
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

PLATE LKG SPINAL LP PROLINK

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698824
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

PLATE LOCKING 10 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688224
Hospital Revenue Code	278
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

PLATE LOCKING 10 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688224
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

PLATE LOCKING DISTAL TI 5 HOLE

Facility

$3,500.00

Hospital Charge Code	270693453
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LOCKING DISTAL TI 5 HOLE

Facility

$3,500.00

Hospital Charge Code	270693453
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$84.35
Rate for Payer: Wellpoint Medicaid Managed Care	$92.75

PLATE LOCKING STRAIGHT SS 10H

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270667332
Hospital Revenue Code	278
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

PLATE LOCKING STRAIGHT SS 10H

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270667332
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

PLATE LOCKING STRAIGHT SS 12H

Facility

$3,475.00

Hospital Charge Code	270671900
Hospital Revenue Code	278
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

PLATE LOCKING STRAIGHT SS 12H

Facility

$3,475.00

Hospital Charge Code	270671900
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

Know your out-of-pocket cost for care.

All Charges