Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE ROTATION 1.6MM

Facility

$4,094.25

Hospital Charge Code	270703049
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$990.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.74
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

PLATE ROTATION 1.6MM

Facility

$4,094.25

Hospital Charge Code	270703049
Hospital Revenue Code	278
Min. Negotiated Rate	$98.67
Max. Negotiated Rate	$2,047.12
Rate for Payer: Aetna Commercial	$1,555.82
Rate for Payer: Aetna Medicare Advantage	$1,228.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,044.03
Rate for Payer: Cigna Commercial	$2,047.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.74
Rate for Payer: Qualcare PPO/HMO/WC	$614.14
Rate for Payer: UnitedHealthcare Community & State	$98.67
Rate for Payer: Wellpoint Medicaid Managed Care	$108.50

PLATE RT CLAVICLE W LATERA EXT

Facility

$4,660.05

Service Code	HCPCS C1776
Hospital Charge Code	270689729
Hospital Revenue Code	278
Min. Negotiated Rate	$699.01
Max. Negotiated Rate	$1,127.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$932.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,127.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,025.21
Rate for Payer: Qualcare PPO/HMO/WC	$699.01

PLATE RT CLAVICLE W LATERA EXT

Facility

$4,660.05

Service Code	HCPCS C1776
Hospital Charge Code	270689729
Hospital Revenue Code	278
Min. Negotiated Rate	$112.31
Max. Negotiated Rate	$2,330.03
Rate for Payer: Aetna Commercial	$1,770.82
Rate for Payer: Aetna Medicare Advantage	$1,398.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,188.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,188.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$932.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,188.31
Rate for Payer: Cigna Commercial	$2,330.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,127.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,025.21
Rate for Payer: Qualcare PPO/HMO/WC	$699.01
Rate for Payer: UnitedHealthcare Community & State	$112.31
Rate for Payer: Wellpoint Medicaid Managed Care	$123.49

PLATE RT OLECRANAN 6HOLE

Facility

$36,250.00

Hospital Charge Code	270662024
Hospital Revenue Code	278
Min. Negotiated Rate	$873.62
Max. Negotiated Rate	$18,125.00
Rate for Payer: Aetna Commercial	$13,775.00
Rate for Payer: Aetna Medicare Advantage	$10,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,243.75
Rate for Payer: Cigna Commercial	$18,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,975.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50
Rate for Payer: UnitedHealthcare Community & State	$873.62
Rate for Payer: Wellpoint Medicaid Managed Care	$960.62

PLATE RT OLECRANAN 6HOLE

Facility

$36,250.00

Hospital Charge Code	270662024
Hospital Revenue Code	278
Min. Negotiated Rate	$5,437.50
Max. Negotiated Rate	$8,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,975.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50

PLATES ANGLE 2.4 2.7MM LEFT

Facility

$6,216.10

Service Code	HCPCS C1713
Hospital Charge Code	270693994
Hospital Revenue Code	278
Min. Negotiated Rate	$932.41
Max. Negotiated Rate	$1,504.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,243.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,504.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,367.54
Rate for Payer: Qualcare PPO/HMO/WC	$932.41

PLATES ANGLE 2.4 2.7MM LEFT

Facility

$6,216.10

Service Code	HCPCS C1713
Hospital Charge Code	270693994
Hospital Revenue Code	278
Min. Negotiated Rate	$149.81
Max. Negotiated Rate	$3,108.05
Rate for Payer: Aetna Commercial	$2,362.12
Rate for Payer: Aetna Medicare Advantage	$1,864.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,585.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,585.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,243.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,585.11
Rate for Payer: Cigna Commercial	$3,108.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,504.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,367.54
Rate for Payer: Qualcare PPO/HMO/WC	$932.41
Rate for Payer: UnitedHealthcare Community & State	$149.81
Rate for Payer: Wellpoint Medicaid Managed Care	$164.73

PLATE SAPPH XCERV SYS 1LEV 9MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694281
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

PLATE SAPPH XCERV SYS 1LEV 9MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694281
Hospital Revenue Code	278
Min. Negotiated Rate	$198.82
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$198.82
Rate for Payer: Wellpoint Medicaid Managed Care	$218.62

PLATE SCP 150mm90DEG 118109006

Facility

$2,228.10

Hospital Charge Code	270625765
Hospital Revenue Code	278
Min. Negotiated Rate	$53.70
Max. Negotiated Rate	$1,114.05
Rate for Payer: Aetna Commercial	$846.68
Rate for Payer: Aetna Medicare Advantage	$668.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$568.17
Rate for Payer: Cigna Commercial	$1,114.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.18
Rate for Payer: Qualcare PPO/HMO/WC	$334.21
Rate for Payer: UnitedHealthcare Community & State	$53.70
Rate for Payer: Wellpoint Medicaid Managed Care	$59.04

PLATE SCP 150mm90DEG 118109006

Facility

$2,228.10

Hospital Charge Code	270625765
Hospital Revenue Code	278
Min. Negotiated Rate	$334.21
Max. Negotiated Rate	$539.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.18
Rate for Payer: Qualcare PPO/HMO/WC	$334.21

PLATE SCREW 6.5X30MM

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697297
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

PLATE SCREW 6.5X30MM

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697297
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

PLATE SDK CERV 23.0MM 876-123

Facility

$4,460.00

Hospital Charge Code	270617699
Hospital Revenue Code	278
Min. Negotiated Rate	$107.49
Max. Negotiated Rate	$2,230.00
Rate for Payer: Aetna Commercial	$1,694.80
Rate for Payer: Aetna Medicare Advantage	$1,338.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.30
Rate for Payer: Cigna Commercial	$2,230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.20
Rate for Payer: Qualcare PPO/HMO/WC	$669.00
Rate for Payer: UnitedHealthcare Community & State	$107.49
Rate for Payer: Wellpoint Medicaid Managed Care	$118.19

PLATE SDK CERV 23.0MM 876-123

Facility

$4,460.00

Hospital Charge Code	270617699
Hospital Revenue Code	278
Min. Negotiated Rate	$669.00
Max. Negotiated Rate	$1,079.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.20
Rate for Payer: Qualcare PPO/HMO/WC	$669.00

PLATE SDK CERV 25.0MM 876-125

Facility

$4,061.65

Hospital Charge Code	270615263
Hospital Revenue Code	278
Min. Negotiated Rate	$97.89
Max. Negotiated Rate	$2,030.83
Rate for Payer: Aetna Commercial	$1,543.43
Rate for Payer: Aetna Medicare Advantage	$1,218.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.72
Rate for Payer: Cigna Commercial	$2,030.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.56
Rate for Payer: Qualcare PPO/HMO/WC	$609.25
Rate for Payer: UnitedHealthcare Community & State	$97.89
Rate for Payer: Wellpoint Medicaid Managed Care	$107.63

PLATE SDK CERV 25.0MM 876-125

Facility

$4,061.65

Hospital Charge Code	270615263
Hospital Revenue Code	278
Min. Negotiated Rate	$609.25
Max. Negotiated Rate	$982.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.56
Rate for Payer: Qualcare PPO/HMO/WC	$609.25

PLATE SDK CERV 42.5MM 876-142

Facility

$4,061.65

Hospital Charge Code	270614733
Hospital Revenue Code	278
Min. Negotiated Rate	$609.25
Max. Negotiated Rate	$982.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.56
Rate for Payer: Qualcare PPO/HMO/WC	$609.25

PLATE SDK CERV 42.5MM 876-142

Facility

$4,061.65

Hospital Charge Code	270614733
Hospital Revenue Code	278
Min. Negotiated Rate	$97.89
Max. Negotiated Rate	$2,030.83
Rate for Payer: Aetna Commercial	$1,543.43
Rate for Payer: Aetna Medicare Advantage	$1,218.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.72
Rate for Payer: Cigna Commercial	$2,030.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.56
Rate for Payer: Qualcare PPO/HMO/WC	$609.25
Rate for Payer: UnitedHealthcare Community & State	$97.89
Rate for Payer: Wellpoint Medicaid Managed Care	$107.63

PLATE SDK CERV 50.0MM 876-150

Facility

$4,855.25

Hospital Charge Code	270618019
Hospital Revenue Code	278
Min. Negotiated Rate	$117.01
Max. Negotiated Rate	$2,427.62
Rate for Payer: Aetna Commercial	$1,844.99
Rate for Payer: Aetna Medicare Advantage	$1,456.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,238.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,238.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$971.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,238.09
Rate for Payer: Cigna Commercial	$2,427.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,068.15
Rate for Payer: Qualcare PPO/HMO/WC	$728.29
Rate for Payer: UnitedHealthcare Community & State	$117.01
Rate for Payer: Wellpoint Medicaid Managed Care	$128.66

PLATE SDK CERV 50.0MM 876-150

Facility

$4,855.25

Hospital Charge Code	270618019
Hospital Revenue Code	278
Min. Negotiated Rate	$728.29
Max. Negotiated Rate	$1,174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$971.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,068.15
Rate for Payer: Qualcare PPO/HMO/WC	$728.29

PLATE SDK CERV 52.5MM 876-152

Facility

$4,855.25

Hospital Charge Code	270618014
Hospital Revenue Code	278
Min. Negotiated Rate	$728.29
Max. Negotiated Rate	$1,174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$971.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,068.15
Rate for Payer: Qualcare PPO/HMO/WC	$728.29

PLATE SDK CERV 52.5MM 876-152

Facility

$4,855.25

Hospital Charge Code	270618014
Hospital Revenue Code	278
Min. Negotiated Rate	$117.01
Max. Negotiated Rate	$2,427.62
Rate for Payer: Aetna Commercial	$1,844.99
Rate for Payer: Aetna Medicare Advantage	$1,456.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,238.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,238.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$971.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,238.09
Rate for Payer: Cigna Commercial	$2,427.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,068.15
Rate for Payer: Qualcare PPO/HMO/WC	$728.29
Rate for Payer: UnitedHealthcare Community & State	$117.01
Rate for Payer: Wellpoint Medicaid Managed Care	$128.66

PLATE SDK CERV 57.5MM 876-157

Facility

$4,424.00

Hospital Charge Code	270616042
Hospital Revenue Code	278
Min. Negotiated Rate	$663.60
Max. Negotiated Rate	$1,070.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$884.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$973.28
Rate for Payer: Qualcare PPO/HMO/WC	$663.60

Know your out-of-pocket cost for care.

All Charges