Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SDK SQUARE SM 015257

Facility

$912.85

Hospital Charge Code	270610686
Hospital Revenue Code	278
Min. Negotiated Rate	$136.93
Max. Negotiated Rate	$220.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.83
Rate for Payer: Qualcare PPO/HMO/WC	$136.93

PLATE SDK SQUARE SM 015257

Facility

$912.85

Hospital Charge Code	270610686
Hospital Revenue Code	278
Min. Negotiated Rate	$22.00
Max. Negotiated Rate	$456.43
Rate for Payer: Aetna Commercial	$346.88
Rate for Payer: Aetna Medicare Advantage	$273.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.78
Rate for Payer: Cigna Commercial	$456.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.83
Rate for Payer: Qualcare PPO/HMO/WC	$136.93
Rate for Payer: UnitedHealthcare Community & State	$22.00
Rate for Payer: Wellpoint Medicaid Managed Care	$24.19

PLATE SELF COMP 2.7 2-HOLE

Facility

$172.00

Hospital Charge Code	1602820
Hospital Revenue Code	274
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.84
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Community & State	$4.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.56

PLATE SELF COMP 2.7 2-HOLE

Facility

$172.00

Hospital Charge Code	1602820
Hospital Revenue Code	274
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.84
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

PLATE SELF COMP 2.7 3-HOLE

Facility

$180.00

Hospital Charge Code	1602838
Hospital Revenue Code	274
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

PLATE SELF COMP 2.7 3-HOLE

Facility

$180.00

Hospital Charge Code	1602838
Hospital Revenue Code	274
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

PLATE SELF COMP 2.7 4-HOLE

Facility

$191.00

Hospital Charge Code	1602846
Hospital Revenue Code	274
Min. Negotiated Rate	$28.65
Max. Negotiated Rate	$46.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.02
Rate for Payer: Qualcare PPO/HMO/WC	$28.65

PLATE SELF COMP 2.7 4-HOLE

Facility

$191.00

Hospital Charge Code	1602846
Hospital Revenue Code	274
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$95.50
Rate for Payer: Aetna Commercial	$72.58
Rate for Payer: Aetna Medicare Advantage	$57.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.70
Rate for Payer: Cigna Commercial	$95.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.02
Rate for Payer: Qualcare PPO/HMO/WC	$28.65
Rate for Payer: UnitedHealthcare Community & State	$4.60
Rate for Payer: Wellpoint Medicaid Managed Care	$5.06

PLATE SELF COMP 2.7 5-HOLE

Facility

$207.00

Hospital Charge Code	1602853
Hospital Revenue Code	274
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$103.50
Rate for Payer: Aetna Commercial	$78.66
Rate for Payer: Aetna Medicare Advantage	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.54
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Community & State	$4.99
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

PLATE SELF COMP 2.7 5-HOLE

Facility

$207.00

Hospital Charge Code	1602853
Hospital Revenue Code	274
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$50.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$45.54
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

PLATE SELF COMP 2.7 6-HOLE

Facility

$229.00

Hospital Charge Code	1602861
Hospital Revenue Code	274
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$114.50
Rate for Payer: Aetna Commercial	$87.02
Rate for Payer: Aetna Medicare Advantage	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.40
Rate for Payer: Cigna Commercial	$114.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.38
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$6.07

PLATE SELF COMP 2.7 6-HOLE

Facility

$229.00

Hospital Charge Code	1602861
Hospital Revenue Code	274
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$55.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.38
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

PLATE SELF COMP 2.7 7-HOLE

Facility

$250.00

Hospital Charge Code	1602879
Hospital Revenue Code	274
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

PLATE SELF COMP 2.7 7-HOLE

Facility

$250.00

Hospital Charge Code	1602879
Hospital Revenue Code	274
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

PLATE SELF COMP 2.7 8-HOLE

Facility

$278.00

Hospital Charge Code	1602887
Hospital Revenue Code	274
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.16
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

PLATE SELF COMP 2.7 8-HOLE

Facility

$278.00

Hospital Charge Code	1602887
Hospital Revenue Code	274
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$105.64
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.16
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

PLATE SEMI TUBULAR 10-HOLE****

Facility

$147.00

Hospital Charge Code	1602499
Hospital Revenue Code	274
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$55.86
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.34
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

PLATE SEMI TUBULAR 10-HOLE****

Facility

$147.00

Hospital Charge Code	1602499
Hospital Revenue Code	274
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$35.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.34
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

PLATE SEMI TUBULAR 11-HOLE***

Facility

$153.00

Hospital Charge Code	1602507
Hospital Revenue Code	274
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$58.14
Rate for Payer: Aetna Medicare Advantage	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.02
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.66
Rate for Payer: Qualcare PPO/HMO/WC	$22.95
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.05

PLATE SEMI TUBULAR 11-HOLE***

Facility

$153.00

Hospital Charge Code	1602507
Hospital Revenue Code	274
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.66
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

PLATE SEMI TUBULAR 12-HOLE***

Facility

$158.00

Hospital Charge Code	1602515
Hospital Revenue Code	274
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$38.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.76
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

PLATE SEMI TUBULAR 12-HOLE***

Facility

$158.00

Hospital Charge Code	1602515
Hospital Revenue Code	274
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$79.00
Rate for Payer: Aetna Commercial	$60.04
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$34.76
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Community & State	$3.81
Rate for Payer: Wellpoint Medicaid Managed Care	$4.19

PLATE SEMI TUBULAR 2-HOLE***

Facility

$93.00

Hospital Charge Code	1602416
Hospital Revenue Code	274
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$46.50
Rate for Payer: Aetna Commercial	$35.34
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.46
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Community & State	$2.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

PLATE SEMI TUBULAR 2-HOLE***

Facility

$93.00

Hospital Charge Code	1602416
Hospital Revenue Code	274
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20.46
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

PLATE SEMI TUBULAR 3-HOLE***

Facility

$98.00

Hospital Charge Code	1602424
Hospital Revenue Code	274
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$21.56
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

Know your out-of-pocket cost for care.

All Charges