Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE PYRENEES LVL 4 77MM

Facility

$8,545.00

Hospital Charge Code	270670320
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE PYRENEES LVL 4 81MM

Facility

$8,545.00

Hospital Charge Code	270670322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE PYRENEES LVL 4 81MM

Facility

$8,545.00

Hospital Charge Code	270670322
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE PYRENEES LVL 4 85MM

Facility

$8,545.00

Hospital Charge Code	270670323
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE PYRENEES LVL 4 85MM

Facility

$8,545.00

Hospital Charge Code	270670323
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE PYRENEES LVL 4 89MM

Facility

$8,545.00

Hospital Charge Code	270670324
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE PYRENEES LVL 4 89MM

Facility

$8,545.00

Hospital Charge Code	270670324
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE PYRENEES LVL 4 93MM

Facility

$8,545.00

Hospital Charge Code	270670325
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE PYRENEES LVL 4 93MM

Facility

$8,545.00

Hospital Charge Code	270670325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE PYRENEES LVL 4 97MM

Facility

$8,545.00

Hospital Charge Code	270670326
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE PYRENEES LVL 4 97MM

Facility

$8,545.00

Hospital Charge Code	270670326
Hospital Revenue Code	278
Min. Negotiated Rate	$205.93
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,879.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$205.93
Rate for Payer: Wellpoint Medicaid Managed Care	$226.44

PLATE PYRENEES LVL 5 100MM

Facility

$9,315.00

Hospital Charge Code	270670327
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENEES LVL 5 100MM

Facility

$9,315.00

Hospital Charge Code	270670327
Hospital Revenue Code	278
Min. Negotiated Rate	$224.49
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$224.49
Rate for Payer: Wellpoint Medicaid Managed Care	$246.85

PLATE PYRENEES LVL 5 105MM

Facility

$9,315.00

Hospital Charge Code	270670328
Hospital Revenue Code	278
Min. Negotiated Rate	$224.49
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$224.49
Rate for Payer: Wellpoint Medicaid Managed Care	$246.85

PLATE PYRENEES LVL 5 105MM

Facility

$9,315.00

Hospital Charge Code	270670328
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENEES LVL 5 110MM

Facility

$9,315.00

Hospital Charge Code	270670329
Hospital Revenue Code	278
Min. Negotiated Rate	$224.49
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$224.49
Rate for Payer: Wellpoint Medicaid Managed Care	$246.85

PLATE PYRENEES LVL 5 110MM

Facility

$9,315.00

Hospital Charge Code	270670329
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENEES LVL 5 95MM

Facility

$9,315.00

Hospital Charge Code	270670330
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENEES LVL 5 95MM

Facility

$9,315.00

Hospital Charge Code	270670330
Hospital Revenue Code	278
Min. Negotiated Rate	$224.49
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,049.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$224.49
Rate for Payer: Wellpoint Medicaid Managed Care	$246.85

PLATE PYRENESS LVL 2 44MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670299
Hospital Revenue Code	278
Min. Negotiated Rate	$167.25
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,526.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$167.25
Rate for Payer: Wellpoint Medicaid Managed Care	$183.91

PLATE PYRENESS LVL 2 44MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670299
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,526.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE QTR TUBULAR 3HOLE 23MM

Facility

$333.70

Service Code	HCPCS C1713
Hospital Charge Code	270604316
Hospital Revenue Code	278
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$166.85
Rate for Payer: Aetna Commercial	$126.81
Rate for Payer: Aetna Medicare Advantage	$100.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.09
Rate for Payer: Cigna Commercial	$166.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.41
Rate for Payer: Qualcare PPO/HMO/WC	$50.05
Rate for Payer: UnitedHealthcare Community & State	$8.04
Rate for Payer: Wellpoint Medicaid Managed Care	$8.84

PLATE QTR TUBULAR 3HOLE 23MM

Facility

$333.70

Service Code	HCPCS C1713
Hospital Charge Code	270604316
Hospital Revenue Code	278
Min. Negotiated Rate	$50.05
Max. Negotiated Rate	$80.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.41
Rate for Payer: Qualcare PPO/HMO/WC	$50.05

PLATE QTR TUBULAR 4HOLE 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270651853
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.90
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PLATE QTR TUBULAR 4HOLE 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270651853
Hospital Revenue Code	278
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.90
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

Know your out-of-pocket cost for care.

All Charges