Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE MTP FUSN 2.4/2.7 10DEG L

Facility

$4,281.00

Hospital Charge Code	270677392
Hospital Revenue Code	278
Min. Negotiated Rate	$642.15
Max. Negotiated Rate	$1,036.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$941.82
Rate for Payer: Qualcare PPO/HMO/WC	$642.15

PLATE MTP FUSN 2.4/2.7 10DEG L

Facility

$4,281.00

Hospital Charge Code	270677392
Hospital Revenue Code	278
Min. Negotiated Rate	$103.17
Max. Negotiated Rate	$2,140.50
Rate for Payer: Aetna Commercial	$1,626.78
Rate for Payer: Aetna Medicare Advantage	$1,284.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,091.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,091.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,091.65
Rate for Payer: Cigna Commercial	$2,140.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$941.82
Rate for Payer: Qualcare PPO/HMO/WC	$642.15
Rate for Payer: UnitedHealthcare Community & State	$103.17
Rate for Payer: Wellpoint Medicaid Managed Care	$113.45

PLATE MTP FUSN2.4/2.7 10DEG LT

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679799
Hospital Revenue Code	278
Min. Negotiated Rate	$661.42
Max. Negotiated Rate	$1,067.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42

PLATE MTP FUSN2.4/2.7 10DEG LT

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679799
Hospital Revenue Code	278
Min. Negotiated Rate	$106.27
Max. Negotiated Rate	$2,204.72
Rate for Payer: Aetna Commercial	$1,675.59
Rate for Payer: Aetna Medicare Advantage	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.41
Rate for Payer: Cigna Commercial	$2,204.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42
Rate for Payer: UnitedHealthcare Community & State	$106.27
Rate for Payer: Wellpoint Medicaid Managed Care	$116.85

PLATE MTP FUSN 2.4/2.7 5DEG LT

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679798
Hospital Revenue Code	278
Min. Negotiated Rate	$661.42
Max. Negotiated Rate	$1,067.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42

PLATE MTP FUSN 2.4/2.7 5DEG LT

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679798
Hospital Revenue Code	278
Min. Negotiated Rate	$106.27
Max. Negotiated Rate	$2,204.72
Rate for Payer: Aetna Commercial	$1,675.59
Rate for Payer: Aetna Medicare Advantage	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.41
Rate for Payer: Cigna Commercial	$2,204.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42
Rate for Payer: UnitedHealthcare Community & State	$106.27
Rate for Payer: Wellpoint Medicaid Managed Care	$116.85

PLATE MTP FUSN 2.4/2.7 LG

Facility

$4,328.45

Service Code	HCPCS C1713
Hospital Charge Code	270680180
Hospital Revenue Code	278
Min. Negotiated Rate	$649.27
Max. Negotiated Rate	$1,047.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$952.26
Rate for Payer: Qualcare PPO/HMO/WC	$649.27

PLATE MTP FUSN 2.4/2.7 LG

Facility

$4,328.45

Service Code	HCPCS C1713
Hospital Charge Code	270680180
Hospital Revenue Code	278
Min. Negotiated Rate	$104.32
Max. Negotiated Rate	$2,164.22
Rate for Payer: Aetna Commercial	$1,644.81
Rate for Payer: Aetna Medicare Advantage	$1,298.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.75
Rate for Payer: Cigna Commercial	$2,164.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$952.26
Rate for Payer: Qualcare PPO/HMO/WC	$649.27
Rate for Payer: UnitedHealthcare Community & State	$104.32
Rate for Payer: Wellpoint Medicaid Managed Care	$114.70

PLATE MTP FUSN 2.4/2.7 LG STER

Facility

$4,409.45

Hospital Charge Code	270677976
Hospital Revenue Code	278
Min. Negotiated Rate	$661.42
Max. Negotiated Rate	$1,067.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42

PLATE MTP FUSN 2.4/2.7 LG STER

Facility

$4,409.45

Hospital Charge Code	270677976
Hospital Revenue Code	278
Min. Negotiated Rate	$106.27
Max. Negotiated Rate	$2,204.72
Rate for Payer: Aetna Commercial	$1,675.59
Rate for Payer: Aetna Medicare Advantage	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.41
Rate for Payer: Cigna Commercial	$2,204.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42
Rate for Payer: UnitedHealthcare Community & State	$106.27
Rate for Payer: Wellpoint Medicaid Managed Care	$116.85

PLATE MTP FUSN 2.4/2.7mm 5DEG

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679436
Hospital Revenue Code	278
Min. Negotiated Rate	$106.27
Max. Negotiated Rate	$2,204.72
Rate for Payer: Aetna Commercial	$1,675.59
Rate for Payer: Aetna Medicare Advantage	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.41
Rate for Payer: Cigna Commercial	$2,204.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42
Rate for Payer: UnitedHealthcare Community & State	$106.27
Rate for Payer: Wellpoint Medicaid Managed Care	$116.85

PLATE MTP FUSN 2.4/2.7mm 5DEG

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679436
Hospital Revenue Code	278
Min. Negotiated Rate	$661.42
Max. Negotiated Rate	$1,067.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$970.08
Rate for Payer: Qualcare PPO/HMO/WC	$661.42

PLATE MTP FUSN SMALL LEFT 5

Facility

$4,668.60

Service Code	HCPCS C1713
Hospital Charge Code	270688734
Hospital Revenue Code	278
Min. Negotiated Rate	$700.29
Max. Negotiated Rate	$1,129.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,027.09
Rate for Payer: Qualcare PPO/HMO/WC	$700.29

PLATE MTP FUSN SMALL LEFT 5

Facility

$4,668.60

Service Code	HCPCS C1713
Hospital Charge Code	270688734
Hospital Revenue Code	278
Min. Negotiated Rate	$112.51
Max. Negotiated Rate	$2,334.30
Rate for Payer: Aetna Commercial	$1,774.07
Rate for Payer: Aetna Medicare Advantage	$1,400.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,190.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,190.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,190.49
Rate for Payer: Cigna Commercial	$2,334.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,027.09
Rate for Payer: Qualcare PPO/HMO/WC	$700.29
Rate for Payer: UnitedHealthcare Community & State	$112.51
Rate for Payer: Wellpoint Medicaid Managed Care	$123.72

PLATE MTP LONG TI 8H V1 RT

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270698992
Hospital Revenue Code	278
Min. Negotiated Rate	$2,621.25
Max. Negotiated Rate	$4,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,844.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25

PLATE MTP LONG TI 8H V1 RT

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270698992
Hospital Revenue Code	278
Min. Negotiated Rate	$421.15
Max. Negotiated Rate	$8,737.50
Rate for Payer: Aetna Commercial	$6,640.50
Rate for Payer: Aetna Medicare Advantage	$5,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,456.12
Rate for Payer: Cigna Commercial	$8,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,844.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25
Rate for Payer: UnitedHealthcare Community & State	$421.15
Rate for Payer: Wellpoint Medicaid Managed Care	$463.09

PLATE MTP LO-PRO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691058
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE MTP LO-PRO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691058
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

PLATE MTP V1 ANCHORAGE LT

Facility

$14,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270695700
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$3,625.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

PLATE MTP V1 ANCHORAGE LT

Facility

$14,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270695700
Hospital Revenue Code	278
Min. Negotiated Rate	$361.02
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$5,692.40
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00
Rate for Payer: UnitedHealthcare Community & State	$361.02
Rate for Payer: Wellpoint Medicaid Managed Care	$396.97

PLATE MTP V1 RIGHT

Facility

$10,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270673313
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 MTP V1 RIGHT

Facility

$10,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270673313
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 MTP V` LONG 8 HOLE

Facility

$10,015.00

Hospital Charge Code	270669555
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 MTP V` LONG 8 HOLE

Facility

$10,015.00

Hospital Charge Code	270669555
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 NARROW 16H 4.5x296MM

Facility

$3,417.00

Hospital Charge Code	270675500
Hospital Revenue Code	278
Min. Negotiated Rate	$82.35
Max. Negotiated Rate	$1,708.50
Rate for Payer: Aetna Commercial	$1,298.46
Rate for Payer: Aetna Medicare Advantage	$1,025.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$683.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$871.34
Rate for Payer: Cigna Commercial	$1,708.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$751.74
Rate for Payer: Qualcare PPO/HMO/WC	$512.55
Rate for Payer: UnitedHealthcare Community & State	$82.35
Rate for Payer: Wellpoint Medicaid Managed Care	$90.55

Know your out-of-pocket cost for care.

All Charges