Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE POW 3.0 MM LOCKING

Facility

$3,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270684783
Hospital Revenue Code	278
Min. Negotiated Rate	$577.50
Max. Negotiated Rate	$931.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$577.50

PLATE POW LOCKING

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684632
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 POW LOCKING

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684632
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 POW LOCKING TI

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674082
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 POW LOCKING TI

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674082
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 PREBENT RIGHT 17 HOLE

Facility

$11,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270690138
Hospital Revenue Code	278
Min. Negotiated Rate	$285.83
Max. Negotiated Rate	$5,930.00
Rate for Payer: Aetna Commercial	$4,506.80
Rate for Payer: Aetna Medicare Advantage	$3,558.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,024.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,024.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,372.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,024.30
Rate for Payer: Cigna Commercial	$5,930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,870.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,609.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,779.00
Rate for Payer: UnitedHealthcare Community & State	$285.83
Rate for Payer: Wellpoint Medicaid Managed Care	$314.29

PLATE PREBENT RIGHT 17 HOLE

Facility

$11,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270690138
Hospital Revenue Code	278
Min. Negotiated Rate	$1,779.00
Max. Negotiated Rate	$2,870.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,870.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,609.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,779.00

PLATE PROX DORL 4H LT 23481004

Facility

$3,655.00

Hospital Charge Code	270641912
Hospital Revenue Code	278
Min. Negotiated Rate	$88.09
Max. Negotiated Rate	$1,827.50
Rate for Payer: Aetna Commercial	$1,388.90
Rate for Payer: Aetna Medicare Advantage	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$932.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$932.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$731.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$932.02
Rate for Payer: Cigna Commercial	$1,827.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$804.10
Rate for Payer: Qualcare PPO/HMO/WC	$548.25
Rate for Payer: UnitedHealthcare Community & State	$88.09
Rate for Payer: Wellpoint Medicaid Managed Care	$96.86

PLATE PROX DORL 4H LT 23481004

Facility

$3,655.00

Hospital Charge Code	270641912
Hospital Revenue Code	278
Min. Negotiated Rate	$548.25
Max. Negotiated Rate	$884.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$731.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$804.10
Rate for Payer: Qualcare PPO/HMO/WC	$548.25

PLATE PROX DORl 6H LT 23481006

Facility

$3,713.95

Hospital Charge Code	270641913
Hospital Revenue Code	278
Min. Negotiated Rate	$89.51
Max. Negotiated Rate	$1,856.97
Rate for Payer: Aetna Commercial	$1,411.30
Rate for Payer: Aetna Medicare Advantage	$1,114.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$947.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$947.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$742.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$947.06
Rate for Payer: Cigna Commercial	$1,856.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$898.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$817.07
Rate for Payer: Qualcare PPO/HMO/WC	$557.09
Rate for Payer: UnitedHealthcare Community & State	$89.51
Rate for Payer: Wellpoint Medicaid Managed Care	$98.42

PLATE PROX DORl 6H LT 23481006

Facility

$3,713.95

Hospital Charge Code	270641913
Hospital Revenue Code	278
Min. Negotiated Rate	$557.09
Max. Negotiated Rate	$898.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$742.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$898.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$817.07
Rate for Payer: Qualcare PPO/HMO/WC	$557.09

PLATE PROX FEMUR 3.4/4.5 12H R

Facility

$16,640.95

Service Code	HCPCS C1713
Hospital Charge Code	270693776
Hospital Revenue Code	278
Min. Negotiated Rate	$2,496.14
Max. Negotiated Rate	$4,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,027.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,661.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,496.14

PLATE PROX FEMUR 3.4/4.5 12H R

Facility

$16,640.95

Service Code	HCPCS C1713
Hospital Charge Code	270693776
Hospital Revenue Code	278
Min. Negotiated Rate	$401.05
Max. Negotiated Rate	$8,320.48
Rate for Payer: Aetna Commercial	$6,323.56
Rate for Payer: Aetna Medicare Advantage	$4,992.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,243.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,243.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,328.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,243.44
Rate for Payer: Cigna Commercial	$8,320.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,027.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,661.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,496.14
Rate for Payer: UnitedHealthcare Community & State	$401.05
Rate for Payer: Wellpoint Medicaid Managed Care	$440.99

PLATE PROXIMAL HUMERAL 4H9mm L

Facility

$6,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270670779
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.75
Max. Negotiated Rate	$1,661.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,510.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75

PLATE PROXIMAL HUMERAL 4H9mm L

Facility

$6,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270670779
Hospital Revenue Code	278
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$3,432.50
Rate for Payer: Aetna Commercial	$2,608.70
Rate for Payer: Aetna Medicare Advantage	$2,059.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,750.58
Rate for Payer: Cigna Commercial	$3,432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,510.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75
Rate for Payer: UnitedHealthcare Community & State	$165.45
Rate for Payer: Wellpoint Medicaid Managed Care	$181.92

PLATE PROXIMAL TIBIA MEDIAL 3.

Facility

$6,220.15

Service Code	HCPCS C1713
Hospital Charge Code	270679035
Hospital Revenue Code	278
Min. Negotiated Rate	$933.02
Max. Negotiated Rate	$1,505.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.43
Rate for Payer: Qualcare PPO/HMO/WC	$933.02

PLATE PROXIMAL TIBIA MEDIAL 3.

Facility

$6,220.15

Service Code	HCPCS C1713
Hospital Charge Code	270679035
Hospital Revenue Code	278
Min. Negotiated Rate	$149.91
Max. Negotiated Rate	$3,110.07
Rate for Payer: Aetna Commercial	$2,363.66
Rate for Payer: Aetna Medicare Advantage	$1,866.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,586.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,586.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,586.14
Rate for Payer: Cigna Commercial	$3,110.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.43
Rate for Payer: Qualcare PPO/HMO/WC	$933.02
Rate for Payer: UnitedHealthcare Community & State	$149.91
Rate for Payer: Wellpoint Medicaid Managed Care	$164.83

PLATE PROXIMAL ULNA 108MM RT

Facility

$8,970.00

Service Code	HCPCS C1713
Hospital Charge Code	270698965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,345.50
Max. Negotiated Rate	$2,170.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,794.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,170.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,973.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.50

PLATE PROXIMAL ULNA 108MM RT

Facility

$8,970.00

Service Code	HCPCS C1713
Hospital Charge Code	270698965
Hospital Revenue Code	278
Min. Negotiated Rate	$216.18
Max. Negotiated Rate	$4,485.00
Rate for Payer: Aetna Commercial	$3,408.60
Rate for Payer: Aetna Medicare Advantage	$2,691.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,287.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,287.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,794.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,287.35
Rate for Payer: Cigna Commercial	$4,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,170.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,973.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.50
Rate for Payer: UnitedHealthcare Community & State	$216.18
Rate for Payer: Wellpoint Medicaid Managed Care	$237.71

PLATE PROX LATERAL 4H 121MM

Facility

$11,785.90

Service Code	HCPCS C1713
Hospital Charge Code	270692171
Hospital Revenue Code	278
Min. Negotiated Rate	$284.04
Max. Negotiated Rate	$5,892.95
Rate for Payer: Aetna Commercial	$4,478.64
Rate for Payer: Aetna Medicare Advantage	$3,535.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,005.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,005.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,357.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,005.40
Rate for Payer: Cigna Commercial	$5,892.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,852.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,592.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.88
Rate for Payer: UnitedHealthcare Community & State	$284.04
Rate for Payer: Wellpoint Medicaid Managed Care	$312.33

PLATE PROX LATERAL 4H 121MM

Facility

$11,785.90

Service Code	HCPCS C1713
Hospital Charge Code	270692171
Hospital Revenue Code	278
Min. Negotiated Rate	$1,767.88
Max. Negotiated Rate	$2,852.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,357.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,852.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,592.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.88

PLATE PSLT DHP LAT SUP 3H

Facility

$6,780.70

Service Code	HCPCS C1713
Hospital Charge Code	270693064
Hospital Revenue Code	278
Min. Negotiated Rate	$163.41
Max. Negotiated Rate	$3,390.35
Rate for Payer: Aetna Commercial	$2,576.67
Rate for Payer: Aetna Medicare Advantage	$2,034.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,729.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,729.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,356.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,729.08
Rate for Payer: Cigna Commercial	$3,390.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,640.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,491.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.11
Rate for Payer: UnitedHealthcare Community & State	$163.41
Rate for Payer: Wellpoint Medicaid Managed Care	$179.69

PLATE PSLT DHP LAT SUP 3H

Facility

$6,780.70

Service Code	HCPCS C1713
Hospital Charge Code	270693064
Hospital Revenue Code	278
Min. Negotiated Rate	$1,017.11
Max. Negotiated Rate	$1,640.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,356.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,640.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,491.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.11

PLATE PYRENEES LVL 1 18MM

Facility

$6,520.00

Hospital Charge Code	270670285
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,434.40
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE PYRENEES LVL 1 18MM

Facility

$6,520.00

Hospital Charge Code	270670285
Hospital Revenue Code	278
Min. Negotiated Rate	$157.13
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,434.40
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$157.13
Rate for Payer: Wellpoint Medicaid Managed Care	$172.78

Know your out-of-pocket cost for care.

All Charges