Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE MEDIAL HOOK LOCK SS 3H

Facility

$4,125.00

Hospital Charge Code	270671901
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
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

PLATE MEDIAL HOOK LOCK SS 5H

Facility

$4,125.00

Hospital Charge Code	270656471
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

PLATE MEDIAL HOOK LOCK SS 5H

Facility

$4,125.00

Hospital Charge Code	270656471
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
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

PLATE MEDIAL HOOK LOCK SS 7H

Facility

$4,500.00

Hospital Charge Code	270671902
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PLATE MEDIAL HOOK LOCK SS 7H

Facility

$4,500.00

Hospital Charge Code	270671902
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

PLATE MEDIAL TIBIA 6H LT 142MM

Facility

$5,931.00

Hospital Charge Code	270675505
Hospital Revenue Code	278
Min. Negotiated Rate	$142.94
Max. Negotiated Rate	$2,965.50
Rate for Payer: Aetna Commercial	$2,253.78
Rate for Payer: Aetna Medicare Advantage	$1,779.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,512.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,512.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,186.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,512.40
Rate for Payer: Cigna Commercial	$2,965.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,435.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,304.82
Rate for Payer: Qualcare PPO/HMO/WC	$889.65
Rate for Payer: UnitedHealthcare Community & State	$142.94
Rate for Payer: Wellpoint Medicaid Managed Care	$157.17

PLATE MEDIAL TIBIA 6H LT 142MM

Facility

$5,931.00

Hospital Charge Code	270675505
Hospital Revenue Code	278
Min. Negotiated Rate	$889.65
Max. Negotiated Rate	$1,435.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,186.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,435.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,304.82
Rate for Payer: Qualcare PPO/HMO/WC	$889.65

PLATE MESH 2.4/2.7MM 12 HOLE

Facility

$7,953.40

Service Code	HCPCS C1713
Hospital Charge Code	270689659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,193.01
Max. Negotiated Rate	$1,924.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,749.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,193.01

PLATE MESH 2.4/2.7MM 12 HOLE

Facility

$7,953.40

Service Code	HCPCS C1713
Hospital Charge Code	270689659
Hospital Revenue Code	278
Min. Negotiated Rate	$191.68
Max. Negotiated Rate	$3,976.70
Rate for Payer: Aetna Commercial	$3,022.29
Rate for Payer: Aetna Medicare Advantage	$2,386.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,028.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,028.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,028.12
Rate for Payer: Cigna Commercial	$3,976.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,749.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,193.01
Rate for Payer: UnitedHealthcare Community & State	$191.68
Rate for Payer: Wellpoint Medicaid Managed Care	$210.77

PLATE METAL 5-HOLE 814116005

Facility

$1,369.00

Hospital Charge Code	270632506
Hospital Revenue Code	278
Min. Negotiated Rate	$205.35
Max. Negotiated Rate	$331.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$301.18
Rate for Payer: Qualcare PPO/HMO/WC	$205.35

PLATE METAL 5-HOLE 814116005

Facility

$1,369.00

Hospital Charge Code	270632506
Hospital Revenue Code	278
Min. Negotiated Rate	$32.99
Max. Negotiated Rate	$684.50
Rate for Payer: Aetna Commercial	$520.22
Rate for Payer: Aetna Medicare Advantage	$410.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.10
Rate for Payer: Cigna Commercial	$684.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$301.18
Rate for Payer: Qualcare PPO/HMO/WC	$205.35
Rate for Payer: UnitedHealthcare Community & State	$32.99
Rate for Payer: Wellpoint Medicaid Managed Care	$36.28

PLATE METAPH 3.5x125MM 10HOLE

Facility

$4,172.55

Service Code	HCPCS C1713
Hospital Charge Code	270680766
Hospital Revenue Code	278
Min. Negotiated Rate	$625.88
Max. Negotiated Rate	$1,009.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$917.96
Rate for Payer: Qualcare PPO/HMO/WC	$625.88

PLATE METAPH 3.5x125MM 10HOLE

Facility

$4,172.55

Service Code	HCPCS C1713
Hospital Charge Code	270680766
Hospital Revenue Code	278
Min. Negotiated Rate	$100.56
Max. Negotiated Rate	$2,086.28
Rate for Payer: Aetna Commercial	$1,585.57
Rate for Payer: Aetna Medicare Advantage	$1,251.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,064.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,064.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,064.00
Rate for Payer: Cigna Commercial	$2,086.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$917.96
Rate for Payer: Qualcare PPO/HMO/WC	$625.88
Rate for Payer: UnitedHealthcare Community & State	$100.56
Rate for Payer: Wellpoint Medicaid Managed Care	$110.57

PLATE METAPH 3.5x125MM 8HOLE

Facility

$3,804.00

Service Code	HCPCS C1713
Hospital Charge Code	270660388
Hospital Revenue Code	278
Min. Negotiated Rate	$91.68
Max. Negotiated Rate	$1,902.00
Rate for Payer: Aetna Commercial	$1,445.52
Rate for Payer: Aetna Medicare Advantage	$1,141.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$970.02
Rate for Payer: Cigna Commercial	$1,902.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$836.88
Rate for Payer: Qualcare PPO/HMO/WC	$570.60
Rate for Payer: UnitedHealthcare Community & State	$91.68
Rate for Payer: Wellpoint Medicaid Managed Care	$100.81

PLATE METAPH 3.5x125MM 8HOLE

Facility

$3,804.00

Service Code	HCPCS C1713
Hospital Charge Code	270660388
Hospital Revenue Code	278
Min. Negotiated Rate	$570.60
Max. Negotiated Rate	$920.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$836.88
Rate for Payer: Qualcare PPO/HMO/WC	$570.60

PLATE METAPH 3.5x190MM 12HOLE

Facility

$5,474.25

Service Code	HCPCS C1713
Hospital Charge Code	270684226
Hospital Revenue Code	278
Min. Negotiated Rate	$131.93
Max. Negotiated Rate	$2,737.12
Rate for Payer: Aetna Commercial	$2,080.22
Rate for Payer: Aetna Medicare Advantage	$1,642.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,395.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,395.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,395.93
Rate for Payer: Cigna Commercial	$2,737.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,204.34
Rate for Payer: Qualcare PPO/HMO/WC	$821.14
Rate for Payer: UnitedHealthcare Community & State	$131.93
Rate for Payer: Wellpoint Medicaid Managed Care	$145.07

PLATE METAPH 3.5x190MM 12HOLE

Facility

$5,474.25

Service Code	HCPCS C1713
Hospital Charge Code	270684226
Hospital Revenue Code	278
Min. Negotiated Rate	$821.14
Max. Negotiated Rate	$1,324.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,204.34
Rate for Payer: Qualcare PPO/HMO/WC	$821.14

PLATE METAPHY 4/5 HOLES 136MM

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270660391
Hospital Revenue Code	278
Min. Negotiated Rate	$93.19
Max. Negotiated Rate	$1,933.50
Rate for Payer: Aetna Commercial	$1,469.46
Rate for Payer: Aetna Medicare Advantage	$1,160.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.09
Rate for Payer: Cigna Commercial	$1,933.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.74
Rate for Payer: Qualcare PPO/HMO/WC	$580.05
Rate for Payer: UnitedHealthcare Community & State	$93.19
Rate for Payer: Wellpoint Medicaid Managed Care	$102.48

PLATE METAPHY 4/5 HOLES 136MM

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270660391
Hospital Revenue Code	278
Min. Negotiated Rate	$580.05
Max. Negotiated Rate	$935.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.74
Rate for Payer: Qualcare PPO/HMO/WC	$580.05

PLATE METAPHYS 4.5/3.5 118mm

Facility

$3,804.00

Hospital Charge Code	270669252
Hospital Revenue Code	278
Min. Negotiated Rate	$570.60
Max. Negotiated Rate	$920.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$836.88
Rate for Payer: Qualcare PPO/HMO/WC	$570.60

PLATE METAPHYS 4.5/3.5 118mm

Facility

$3,804.00

Hospital Charge Code	270669252
Hospital Revenue Code	278
Min. Negotiated Rate	$91.68
Max. Negotiated Rate	$1,902.00
Rate for Payer: Aetna Commercial	$1,445.52
Rate for Payer: Aetna Medicare Advantage	$1,141.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$970.02
Rate for Payer: Cigna Commercial	$1,902.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$836.88
Rate for Payer: Qualcare PPO/HMO/WC	$570.60
Rate for Payer: UnitedHealthcare Community & State	$91.68
Rate for Payer: Wellpoint Medicaid Managed Care	$100.81

PLATE METAPHYS 4.5/3.5 190mm

Facility

$5,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270669505
Hospital Revenue Code	278
Min. Negotiated Rate	$124.36
Max. Negotiated Rate	$2,580.00
Rate for Payer: Aetna Commercial	$1,960.80
Rate for Payer: Aetna Medicare Advantage	$1,548.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,315.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,315.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,032.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,315.80
Rate for Payer: Cigna Commercial	$2,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,248.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,135.20
Rate for Payer: Qualcare PPO/HMO/WC	$774.00
Rate for Payer: UnitedHealthcare Community & State	$124.36
Rate for Payer: Wellpoint Medicaid Managed Care	$136.74

PLATE METAPHYS 4.5/3.5 190mm

Facility

$5,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270669505
Hospital Revenue Code	278
Min. Negotiated Rate	$774.00
Max. Negotiated Rate	$1,248.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,032.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,248.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,135.20
Rate for Payer: Qualcare PPO/HMO/WC	$774.00

PLATE METAPHYSEAL 4.5/3.5 11H

Facility

$3,996.00

Service Code	HCPCS C1713
Hospital Charge Code	270674861
Hospital Revenue Code	278
Min. Negotiated Rate	$599.40
Max. Negotiated Rate	$967.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$799.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$967.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$879.12
Rate for Payer: Qualcare PPO/HMO/WC	$599.40

PLATE METAPHYSEAL 4.5/3.5 11H

Facility

$3,996.00

Service Code	HCPCS C1713
Hospital Charge Code	270674861
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$1,998.00
Rate for Payer: Aetna Commercial	$1,518.48
Rate for Payer: Aetna Medicare Advantage	$1,198.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,018.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,018.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$799.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,018.98
Rate for Payer: Cigna Commercial	$1,998.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$967.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$879.12
Rate for Payer: Qualcare PPO/HMO/WC	$599.40
Rate for Payer: UnitedHealthcare Community & State	$96.30
Rate for Payer: Wellpoint Medicaid Managed Care	$105.89

Know your out-of-pocket cost for care.

All Charges