Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LOCKING STRAIGHT SS 4H

Facility

$2,250.00

Hospital Charge Code	270671896
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

PLATE LOCKING STRAIGHT SS 4H

Facility

$2,250.00

Hospital Charge Code	270671896
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

PLATE LOCKING STRAIGHT SS 6H

Facility

$2,375.00

Hospital Charge Code	270671897
Hospital Revenue Code	278
Min. Negotiated Rate	$57.24
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$522.50
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Community & State	$57.24
Rate for Payer: Wellpoint Medicaid Managed Care	$62.94

PLATE LOCKING STRAIGHT SS 6H

Facility

$2,375.00

Hospital Charge Code	270671897
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$522.50
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

PLATE LOCKING STRAIGHT SS 7H

Facility

$2,625.00

Hospital Charge Code	270671898
Hospital Revenue Code	278
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

PLATE LOCKING STRAIGHT SS 7H

Facility

$2,625.00

Hospital Charge Code	270671898
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

PLATE LOCKING STRAIGHT SS 8H

Facility

$2,750.00

Hospital Charge Code	270671899
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

PLATE LOCKING STRAIGHT SS 8H

Facility

$2,750.00

Hospital Charge Code	270671899
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

PLATE LOCKING TUBUL 3RD TI 4H

Facility

$1,150.00

Hospital Charge Code	270702504
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

PLATE LOCKING TUBUL 3RD TI 4H

Facility

$1,150.00

Hospital Charge Code	270702504
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

PLATE LOCK LAT HOOK TI 3H

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696717
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATE LOCK LAT HOOK TI 3H

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696717
Hospital Revenue Code	278
Min. Negotiated Rate	$111.46
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$111.46
Rate for Payer: Wellpoint Medicaid Managed Care	$122.56

PLATELONG FOOT MAX 180 MM ALUM

Facility

$8,157.00

Hospital Charge Code	270681230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,223.55
Max. Negotiated Rate	$1,223.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.55

PLATELONG FOOT MAX 180 MM ALUM

Facility

$8,157.00

Hospital Charge Code	270681230
Hospital Revenue Code	272
Min. Negotiated Rate	$196.58
Max. Negotiated Rate	$4,078.50
Rate for Payer: Aetna Commercial	$3,099.66
Rate for Payer: Aetna Medicare Advantage	$2,447.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,080.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,080.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,080.03
Rate for Payer: Cigna Commercial	$4,078.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,447.10
Rate for Payer: Oxford Commercial	$1,631.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.55
Rate for Payer: UnitedHealthcare Commercial	$1,631.40
Rate for Payer: UnitedHealthcare Community & State	$196.58
Rate for Payer: Wellpoint Medicaid Managed Care	$216.16

PLATELONG MAXFRAME 150MM

Facility

$6,933.00

Hospital Charge Code	270681231
Hospital Revenue Code	272
Min. Negotiated Rate	$1,039.95
Max. Negotiated Rate	$1,039.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.95

PLATELONG MAXFRAME 150MM

Facility

$6,933.00

Hospital Charge Code	270681231
Hospital Revenue Code	272
Min. Negotiated Rate	$167.09
Max. Negotiated Rate	$3,466.50
Rate for Payer: Aetna Commercial	$2,634.54
Rate for Payer: Aetna Medicare Advantage	$2,079.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,767.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,767.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,767.91
Rate for Payer: Cigna Commercial	$3,466.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,079.90
Rate for Payer: Oxford Commercial	$1,386.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.95
Rate for Payer: UnitedHealthcare Commercial	$1,386.60
Rate for Payer: UnitedHealthcare Community & State	$167.09
Rate for Payer: Wellpoint Medicaid Managed Care	$183.72

PLATE LONG ROI-C FOR H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678667
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE LONG ROI-C FOR H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678667
Hospital Revenue Code	278
Min. Negotiated Rate	$281.17
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$281.17
Rate for Payer: Wellpoint Medicaid Managed Care	$309.17

PLATE LORDOTIC 10X28X11MM ST

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692443
Hospital Revenue Code	278
Min. Negotiated Rate	$583.22
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$9,196.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00
Rate for Payer: UnitedHealthcare Community & State	$583.22
Rate for Payer: Wellpoint Medicaid Managed Care	$641.30

PLATE LORDOTIC 10X28X11MM ST

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDOTIC 10X29X9MM COAL

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692450
Hospital Revenue Code	278
Min. Negotiated Rate	$583.22
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$9,196.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00
Rate for Payer: UnitedHealthcare Community & State	$583.22
Rate for Payer: Wellpoint Medicaid Managed Care	$641.30

PLATE LORDOTIC 10X29X9MM COAL

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692450
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDTIC 28 MM

Facility

$6,590.00

Service Code	HCPCS C1889
Hospital Charge Code	270690569
Hospital Revenue Code	278
Min. Negotiated Rate	$988.50
Max. Negotiated Rate	$1,594.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,318.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,594.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,449.80
Rate for Payer: Qualcare PPO/HMO/WC	$988.50

PLATE LORDTIC 28 MM

Facility

$6,590.00

Service Code	HCPCS C1889
Hospital Charge Code	270690569
Hospital Revenue Code	278
Min. Negotiated Rate	$158.82
Max. Negotiated Rate	$3,295.00
Rate for Payer: Aetna Commercial	$2,504.20
Rate for Payer: Aetna Medicare Advantage	$1,977.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.45
Rate for Payer: Cigna Commercial	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,594.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,449.80
Rate for Payer: Qualcare PPO/HMO/WC	$988.50
Rate for Payer: UnitedHealthcare Community & State	$158.82
Rate for Payer: Wellpoint Medicaid Managed Care	$174.63

PLATE LORDTIC 30MM

Facility

$6,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270690567
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

Know your out-of-pocket cost for care.

All Charges