Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE MAXFORCE MTP 6-5 LEFT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694413
Hospital Revenue Code	278
Min. Negotiated Rate	$240.40
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$240.40
Rate for Payer: Wellpoint Medicaid Managed Care	$264.34

PLATE MAXFORCE MTP 6-5 LEFT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694413
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

PLATE MAXFRAME FOOT 150MM

Facility

$7,015.65

Hospital Charge Code	270693737
Hospital Revenue Code	272
Min. Negotiated Rate	$1,052.35
Max. Negotiated Rate	$1,052.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.35

PLATE MAXFRAME FOOT 150MM

Facility

$7,015.65

Hospital Charge Code	270693737
Hospital Revenue Code	272
Min. Negotiated Rate	$169.08
Max. Negotiated Rate	$3,507.82
Rate for Payer: Aetna Commercial	$2,665.95
Rate for Payer: Aetna Medicare Advantage	$2,104.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,788.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,788.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,788.99
Rate for Payer: Cigna Commercial	$3,507.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,104.70
Rate for Payer: Oxford Commercial	$1,403.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.35
Rate for Payer: UnitedHealthcare Commercial	$1,403.13
Rate for Payer: UnitedHealthcare Community & State	$169.08
Rate for Payer: Wellpoint Medicaid Managed Care	$185.91

PLATE MC5 RIGHT 5 HOLE

Facility

$3,680.00

Hospital Charge Code	270669579
Hospital Revenue Code	278
Min. Negotiated Rate	$552.00
Max. Negotiated Rate	$890.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$736.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$890.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$809.60
Rate for Payer: Qualcare PPO/HMO/WC	$552.00

PLATE MC5 RIGHT 5 HOLE

Facility

$3,680.00

Hospital Charge Code	270669579
Hospital Revenue Code	278
Min. Negotiated Rate	$88.69
Max. Negotiated Rate	$1,840.00
Rate for Payer: Aetna Commercial	$1,398.40
Rate for Payer: Aetna Medicare Advantage	$1,104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$938.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$938.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$736.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$938.40
Rate for Payer: Cigna Commercial	$1,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$890.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$809.60
Rate for Payer: Qualcare PPO/HMO/WC	$552.00
Rate for Payer: UnitedHealthcare Community & State	$88.69
Rate for Payer: Wellpoint Medicaid Managed Care	$97.52

PLATE MDL 10-H RT 1312-18-701

Facility

$6,415.00

Hospital Charge Code	270658885
Hospital Revenue Code	278
Min. Negotiated Rate	$154.60
Max. Negotiated Rate	$3,207.50
Rate for Payer: Aetna Commercial	$2,437.70
Rate for Payer: Aetna Medicare Advantage	$1,924.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,635.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,635.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,283.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,635.83
Rate for Payer: Cigna Commercial	$3,207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,552.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,411.30
Rate for Payer: Qualcare PPO/HMO/WC	$962.25
Rate for Payer: UnitedHealthcare Community & State	$154.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.00

PLATE MDL 10-H RT 1312-18-701

Facility

$6,415.00

Hospital Charge Code	270658885
Hospital Revenue Code	278
Min. Negotiated Rate	$962.25
Max. Negotiated Rate	$1,552.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,283.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,552.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,411.30
Rate for Payer: Qualcare PPO/HMO/WC	$962.25

PLATE MED CALCANEUS

Facility

$3,094.30

Service Code	HCPCS C1713
Hospital Charge Code	270703985
Hospital Revenue Code	278
Min. Negotiated Rate	$74.57
Max. Negotiated Rate	$1,547.15
Rate for Payer: Aetna Commercial	$1,175.83
Rate for Payer: Aetna Medicare Advantage	$928.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$789.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$789.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$618.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$789.05
Rate for Payer: Cigna Commercial	$1,547.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$748.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$680.75
Rate for Payer: Qualcare PPO/HMO/WC	$464.14
Rate for Payer: UnitedHealthcare Community & State	$74.57
Rate for Payer: Wellpoint Medicaid Managed Care	$82.00

PLATE MED CALCANEUS

Facility

$3,094.30

Service Code	HCPCS C1713
Hospital Charge Code	270703985
Hospital Revenue Code	278
Min. Negotiated Rate	$464.14
Max. Negotiated Rate	$748.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$618.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$748.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$680.75
Rate for Payer: Qualcare PPO/HMO/WC	$464.14

PLATE MED DIS 10H RT 234700710

Facility

$3,223.70

Hospital Charge Code	270634235
Hospital Revenue Code	278
Min. Negotiated Rate	$77.69
Max. Negotiated Rate	$1,611.85
Rate for Payer: Aetna Commercial	$1,225.01
Rate for Payer: Aetna Medicare Advantage	$967.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.04
Rate for Payer: Cigna Commercial	$1,611.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.21
Rate for Payer: Qualcare PPO/HMO/WC	$483.56
Rate for Payer: UnitedHealthcare Community & State	$77.69
Rate for Payer: Wellpoint Medicaid Managed Care	$85.43

PLATE MED DIS 10H RT 234700710

Facility

$3,223.70

Hospital Charge Code	270634235
Hospital Revenue Code	278
Min. Negotiated Rate	$483.56
Max. Negotiated Rate	$780.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.21
Rate for Payer: Qualcare PPO/HMO/WC	$483.56

PLATE MED DISTAL TIB 234700806

Facility

$2,951.25

Hospital Charge Code	270630826
Hospital Revenue Code	278
Min. Negotiated Rate	$442.69
Max. Negotiated Rate	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$714.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$649.27
Rate for Payer: Qualcare PPO/HMO/WC	$442.69

PLATE MED DISTAL TIB 234700806

Facility

$2,951.25

Hospital Charge Code	270630826
Hospital Revenue Code	278
Min. Negotiated Rate	$71.13
Max. Negotiated Rate	$1,475.62
Rate for Payer: Aetna Commercial	$1,121.47
Rate for Payer: Aetna Medicare Advantage	$885.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.57
Rate for Payer: Cigna Commercial	$1,475.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$714.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$649.27
Rate for Payer: Qualcare PPO/HMO/WC	$442.69
Rate for Payer: UnitedHealthcare Community & State	$71.13
Rate for Payer: Wellpoint Medicaid Managed Care	$78.21

PLATE MEDIAL 12 HOLES LF 198MM

Facility

$11,065.00

Hospital Charge Code	270670936
Hospital Revenue Code	278
Min. Negotiated Rate	$1,659.75
Max. Negotiated Rate	$2,677.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,677.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,434.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.75

PLATE MEDIAL 12 HOLES LF 198MM

Facility

$11,065.00

Hospital Charge Code	270670936
Hospital Revenue Code	278
Min. Negotiated Rate	$266.67
Max. Negotiated Rate	$5,532.50
Rate for Payer: Aetna Commercial	$4,204.70
Rate for Payer: Aetna Medicare Advantage	$3,319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,821.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,821.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,821.57
Rate for Payer: Cigna Commercial	$5,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,677.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,434.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.75
Rate for Payer: UnitedHealthcare Community & State	$266.67
Rate for Payer: Wellpoint Medicaid Managed Care	$293.22

PLATE MEDIAL 4 HOLE 92MM

Facility

$7,995.00

Hospital Charge Code	270670987
Hospital Revenue Code	278
Min. Negotiated Rate	$1,199.25
Max. Negotiated Rate	$1,934.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,758.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25

PLATE MEDIAL 4 HOLE 92MM

Facility

$7,995.00

Hospital Charge Code	270670987
Hospital Revenue Code	278
Min. Negotiated Rate	$192.68
Max. Negotiated Rate	$3,997.50
Rate for Payer: Aetna Commercial	$3,038.10
Rate for Payer: Aetna Medicare Advantage	$2,398.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,038.72
Rate for Payer: Cigna Commercial	$3,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,758.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25
Rate for Payer: UnitedHealthcare Community & State	$192.68
Rate for Payer: Wellpoint Medicaid Managed Care	$211.87

PLATE MEDIAL 8HOLE LOCKING

Facility

$3,170.00

Hospital Charge Code	270638089
Hospital Revenue Code	278
Min. Negotiated Rate	$76.40
Max. Negotiated Rate	$1,585.00
Rate for Payer: Aetna Commercial	$1,204.60
Rate for Payer: Aetna Medicare Advantage	$951.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$808.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$808.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$808.35
Rate for Payer: Cigna Commercial	$1,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.40
Rate for Payer: Qualcare PPO/HMO/WC	$475.50
Rate for Payer: UnitedHealthcare Community & State	$76.40
Rate for Payer: Wellpoint Medicaid Managed Care	$84.00

PLATE MEDIAL 8HOLE LOCKING

Facility

$3,170.00

Hospital Charge Code	270638089
Hospital Revenue Code	278
Min. Negotiated Rate	$475.50
Max. Negotiated Rate	$767.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.40
Rate for Payer: Qualcare PPO/HMO/WC	$475.50

PLATE MEDIAL 9HOLE LOCKING

Facility

$3,170.00

Hospital Charge Code	270638090
Hospital Revenue Code	278
Min. Negotiated Rate	$76.40
Max. Negotiated Rate	$1,585.00
Rate for Payer: Aetna Commercial	$1,204.60
Rate for Payer: Aetna Medicare Advantage	$951.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$808.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$808.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$808.35
Rate for Payer: Cigna Commercial	$1,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.40
Rate for Payer: Qualcare PPO/HMO/WC	$475.50
Rate for Payer: UnitedHealthcare Community & State	$76.40
Rate for Payer: Wellpoint Medicaid Managed Care	$84.00

PLATE MEDIAL 9HOLE LOCKING

Facility

$3,170.00

Hospital Charge Code	270638090
Hospital Revenue Code	278
Min. Negotiated Rate	$475.50
Max. Negotiated Rate	$767.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$697.40
Rate for Payer: Qualcare PPO/HMO/WC	$475.50

PLATE MEDIAL COLM FUS 95MM RT

Facility

$5,871.00

Service Code	HCPCS C1713
Hospital Charge Code	270674858
Hospital Revenue Code	278
Min. Negotiated Rate	$141.49
Max. Negotiated Rate	$2,935.50
Rate for Payer: Aetna Commercial	$2,230.98
Rate for Payer: Aetna Medicare Advantage	$1,761.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,497.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,497.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,174.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,497.11
Rate for Payer: Cigna Commercial	$2,935.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,420.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,291.62
Rate for Payer: Qualcare PPO/HMO/WC	$880.65
Rate for Payer: UnitedHealthcare Community & State	$141.49
Rate for Payer: Wellpoint Medicaid Managed Care	$155.58

PLATE MEDIAL COLM FUS 95MM RT

Facility

$5,871.00

Service Code	HCPCS C1713
Hospital Charge Code	270674858
Hospital Revenue Code	278
Min. Negotiated Rate	$880.65
Max. Negotiated Rate	$1,420.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,174.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,420.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,291.62
Rate for Payer: Qualcare PPO/HMO/WC	$880.65

PLATE MEDIAL HOOK LOCK SS 3H

Facility

$4,125.00

Hospital Charge Code	270671901
Hospital Revenue Code	278
Min. Negotiated Rate	$99.41
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Community & State	$99.41
Rate for Payer: Wellpoint Medicaid Managed Care	$109.31

Know your out-of-pocket cost for care.

All Charges