Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE RECON CVD 3.5MM 18H

Facility

$2,269.65

Hospital Charge Code	270604393
Hospital Revenue Code	278
Min. Negotiated Rate	$340.45
Max. Negotiated Rate	$549.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$499.32
Rate for Payer: Qualcare PPO/HMO/WC	$340.45

PLATE RECON CVD 3.5MM 6H

Facility

$2,317.65

Hospital Charge Code	270604387
Hospital Revenue Code	278
Min. Negotiated Rate	$347.65
Max. Negotiated Rate	$560.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$509.88
Rate for Payer: Qualcare PPO/HMO/WC	$347.65

PLATE RECON CVD 3.5MM 6H

Facility

$2,317.65

Hospital Charge Code	270604387
Hospital Revenue Code	278
Min. Negotiated Rate	$55.86
Max. Negotiated Rate	$1,158.83
Rate for Payer: Aetna Commercial	$880.71
Rate for Payer: Aetna Medicare Advantage	$695.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$591.00
Rate for Payer: Cigna Commercial	$1,158.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$509.88
Rate for Payer: Qualcare PPO/HMO/WC	$347.65
Rate for Payer: UnitedHealthcare Community & State	$55.86
Rate for Payer: Wellpoint Medicaid Managed Care	$61.42

PLATE RECON CVD 3.5MM 8H

Facility

$1,572.00

Hospital Charge Code	270604388
Hospital Revenue Code	278
Min. Negotiated Rate	$235.80
Max. Negotiated Rate	$380.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80

PLATE RECON CVD 3.5MM 8H

Facility

$1,572.00

Hospital Charge Code	270604388
Hospital Revenue Code	278
Min. Negotiated Rate	$37.89
Max. Negotiated Rate	$786.00
Rate for Payer: Aetna Commercial	$597.36
Rate for Payer: Aetna Medicare Advantage	$471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.86
Rate for Payer: Cigna Commercial	$786.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80
Rate for Payer: UnitedHealthcare Community & State	$37.89
Rate for Payer: Wellpoint Medicaid Managed Care	$41.66

PLATE RECONS 10 HOLES 4x120MM

Facility

$4,595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673000
Hospital Revenue Code	278
Min. Negotiated Rate	$689.25
Max. Negotiated Rate	$1,111.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$919.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,010.90
Rate for Payer: Qualcare PPO/HMO/WC	$689.25

PLATE RECONS 10 HOLES 4x120MM

Facility

$4,595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673000
Hospital Revenue Code	278
Min. Negotiated Rate	$110.74
Max. Negotiated Rate	$2,297.50
Rate for Payer: Aetna Commercial	$1,746.10
Rate for Payer: Aetna Medicare Advantage	$1,378.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,171.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,171.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$919.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,171.72
Rate for Payer: Cigna Commercial	$2,297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,010.90
Rate for Payer: Qualcare PPO/HMO/WC	$689.25
Rate for Payer: UnitedHealthcare Community & State	$110.74
Rate for Payer: Wellpoint Medicaid Managed Care	$121.77

PLATE REGATTA 14MM 2HOLE

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693475
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,675.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

PLATE REGATTA 14MM 2HOLE

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693475
Hospital Revenue Code	278
Min. Negotiated Rate	$512.12
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$8,075.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,675.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50
Rate for Payer: UnitedHealthcare Community & State	$512.12
Rate for Payer: Wellpoint Medicaid Managed Care	$563.12

PLATE REPLICATOR 1.5MM OFFSET

Facility

$5,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270670755
Hospital Revenue Code	278
Min. Negotiated Rate	$824.25
Max. Negotiated Rate	$1,329.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,208.90
Rate for Payer: Qualcare PPO/HMO/WC	$824.25

PLATE REPLICATOR 1.5MM OFFSET

Facility

$5,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270670755
Hospital Revenue Code	278
Min. Negotiated Rate	$132.43
Max. Negotiated Rate	$2,747.50
Rate for Payer: Aetna Commercial	$2,088.10
Rate for Payer: Aetna Medicare Advantage	$1,648.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,401.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,401.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,401.22
Rate for Payer: Cigna Commercial	$2,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,208.90
Rate for Payer: Qualcare PPO/HMO/WC	$824.25
Rate for Payer: UnitedHealthcare Community & State	$132.43
Rate for Payer: Wellpoint Medicaid Managed Care	$145.62

PLATE REPLICATOR 4.5MM OFFSET

Facility

$5,495.55

Hospital Charge Code	270669869
Hospital Revenue Code	278
Min. Negotiated Rate	$824.33
Max. Negotiated Rate	$1,329.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,209.02
Rate for Payer: Qualcare PPO/HMO/WC	$824.33

PLATE REPLICATOR 4.5MM OFFSET

Facility

$5,495.55

Hospital Charge Code	270669869
Hospital Revenue Code	278
Min. Negotiated Rate	$132.44
Max. Negotiated Rate	$2,747.78
Rate for Payer: Aetna Commercial	$2,088.31
Rate for Payer: Aetna Medicare Advantage	$1,648.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,401.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,401.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,401.37
Rate for Payer: Cigna Commercial	$2,747.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,209.02
Rate for Payer: Qualcare PPO/HMO/WC	$824.33
Rate for Payer: UnitedHealthcare Community & State	$132.44
Rate for Payer: Wellpoint Medicaid Managed Care	$145.63

PLATE RIGHT 4 HOLES OLECRANON

Facility

$7,995.00

Hospital Charge Code	270669709
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 RIGHT 4 HOLES OLECRANON

Facility

$7,995.00

Hospital Charge Code	270669709
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 RIGHT PRIMARY MPJ FUSION

Facility

$8,500.00

Hospital Charge Code	270669678
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

PLATE RIGHT PRIMARY MPJ FUSION

Facility

$8,500.00

Hospital Charge Code	270669678
Hospital Revenue Code	278
Min. Negotiated Rate	$204.85
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$204.85
Rate for Payer: Wellpoint Medicaid Managed Care	$225.25

PLATE RIGHT T

Facility

$5,865.00

Hospital Charge Code	270702598
Hospital Revenue Code	278
Min. Negotiated Rate	$879.75
Max. Negotiated Rate	$1,419.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,419.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,290.30
Rate for Payer: Qualcare PPO/HMO/WC	$879.75

PLATE RIGHT T

Facility

$5,865.00

Hospital Charge Code	270702598
Hospital Revenue Code	278
Min. Negotiated Rate	$141.35
Max. Negotiated Rate	$2,932.50
Rate for Payer: Aetna Commercial	$2,228.70
Rate for Payer: Aetna Medicare Advantage	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,495.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,495.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,495.58
Rate for Payer: Cigna Commercial	$2,932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,419.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,290.30
Rate for Payer: Qualcare PPO/HMO/WC	$879.75
Rate for Payer: UnitedHealthcare Community & State	$141.35
Rate for Payer: Wellpoint Medicaid Managed Care	$155.42

PLATE ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270679749
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270679749
Hospital Revenue Code	278
Min. Negotiated Rate	$281.17
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$281.17
Rate for Payer: Wellpoint Medicaid Managed Care	$309.17

PLATE ROI C ANCHORING 12 X 14X

Facility

$20,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691010
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

PLATE ROI C ANCHORING 12 X 14X

Facility

$20,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691010
Hospital Revenue Code	278
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$482.00
Rate for Payer: Wellpoint Medicaid Managed Care	$530.00

PLATE ROT 2.0MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689901
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE ROT 2.0MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689901
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

Know your out-of-pocket cost for care.

All Charges