Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE STRAIGHT 1.5MM 12HOLE

Facility

$1,053.70

Service Code	HCPCS C1713
Hospital Charge Code	270654814
Hospital Revenue Code	278
Min. Negotiated Rate	$25.39
Max. Negotiated Rate	$526.85
Rate for Payer: Aetna Commercial	$400.41
Rate for Payer: Aetna Medicare Advantage	$316.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.69
Rate for Payer: Cigna Commercial	$526.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.81
Rate for Payer: Qualcare PPO/HMO/WC	$158.06
Rate for Payer: UnitedHealthcare Community & State	$25.39
Rate for Payer: Wellpoint Medicaid Managed Care	$27.92

PLATE STRAIGHT 1.5MM 6HOLE

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270654812
Hospital Revenue Code	278
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$20.11
Rate for Payer: Wellpoint Medicaid Managed Care	$22.11

PLATE STRAIGHT 1.5MM 6HOLE

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270654812
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$183.55
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

PLATE STRAIGHT 2.0MM 12HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654825
Hospital Revenue Code	278
Min. Negotiated Rate	$26.44
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$416.84
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54
Rate for Payer: UnitedHealthcare Community & State	$26.44
Rate for Payer: Wellpoint Medicaid Managed Care	$29.07

PLATE STRAIGHT 2.0MM 12HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654825
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

PLATE STRAIGHT 2.0MM 6HOLE

Facility

$945.30

Service Code	HCPCS C1713
Hospital Charge Code	270654824
Hospital Revenue Code	278
Min. Negotiated Rate	$141.79
Max. Negotiated Rate	$228.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.97
Rate for Payer: Qualcare PPO/HMO/WC	$141.79

PLATE STRAIGHT 2.0MM 6HOLE

Facility

$945.30

Service Code	HCPCS C1713
Hospital Charge Code	270654824
Hospital Revenue Code	278
Min. Negotiated Rate	$22.78
Max. Negotiated Rate	$472.65
Rate for Payer: Aetna Commercial	$359.21
Rate for Payer: Aetna Medicare Advantage	$283.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.05
Rate for Payer: Cigna Commercial	$472.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$207.97
Rate for Payer: Qualcare PPO/HMO/WC	$141.79
Rate for Payer: UnitedHealthcare Community & State	$22.78
Rate for Payer: Wellpoint Medicaid Managed Care	$25.05

PLATE STRAIGHT 2.4MM 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694872
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

PLATE STRAIGHT 2.4MM 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694872
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 STRAIGHT 6 HOLE

Facility

$75.00

Service Code	HCPCS C1713
Hospital Charge Code	270698544
Hospital Revenue Code	278
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

PLATE STRAIGHT 6 HOLE

Facility

$75.00

Service Code	HCPCS C1713
Hospital Charge Code	270698544
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

PLATE STRAIGHT 6HOLE 2.0MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694674
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

PLATE STRAIGHT 6HOLE 2.0MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694674
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 STRAIGHT 8 HOLE W / COMP

Facility

$4,111.25

Service Code	HCPCS C1713
Hospital Charge Code	270701753
Hospital Revenue Code	278
Min. Negotiated Rate	$616.69
Max. Negotiated Rate	$994.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$994.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$904.48
Rate for Payer: Qualcare PPO/HMO/WC	$616.69

PLATE STRAIGHT 8 HOLE W / COMP

Facility

$4,111.25

Service Code	HCPCS C1713
Hospital Charge Code	270701753
Hospital Revenue Code	278
Min. Negotiated Rate	$99.08
Max. Negotiated Rate	$2,055.62
Rate for Payer: Aetna Commercial	$1,562.28
Rate for Payer: Aetna Medicare Advantage	$1,233.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,048.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,048.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,048.37
Rate for Payer: Cigna Commercial	$2,055.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$994.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$904.48
Rate for Payer: Qualcare PPO/HMO/WC	$616.69
Rate for Payer: UnitedHealthcare Community & State	$99.08
Rate for Payer: Wellpoint Medicaid Managed Care	$108.95

PLATE STRA TUB 8 HOLE

Facility

$2,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270701131
Hospital Revenue Code	278
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$625.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$568.70
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

PLATE STRA TUB 8 HOLE

Facility

$2,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270701131
Hospital Revenue Code	278
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$1,292.50
Rate for Payer: Aetna Commercial	$982.30
Rate for Payer: Aetna Medicare Advantage	$775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.17
Rate for Payer: Cigna Commercial	$1,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$568.70
Rate for Payer: Qualcare PPO/HMO/WC	$387.75
Rate for Payer: UnitedHealthcare Community & State	$62.30
Rate for Payer: Wellpoint Medicaid Managed Care	$68.50

PLATE STRM STRAIGHT 6HOLE

Facility

$5,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270694321
Hospital Revenue Code	278
Min. Negotiated Rate	$828.75
Max. Negotiated Rate	$1,337.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,215.50
Rate for Payer: Qualcare PPO/HMO/WC	$828.75

PLATE STRM STRAIGHT 6HOLE

Facility

$5,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270694321
Hospital Revenue Code	278
Min. Negotiated Rate	$133.15
Max. Negotiated Rate	$2,762.50
Rate for Payer: Aetna Commercial	$2,099.50
Rate for Payer: Aetna Medicare Advantage	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,408.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,408.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,408.88
Rate for Payer: Cigna Commercial	$2,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,215.50
Rate for Payer: Qualcare PPO/HMO/WC	$828.75
Rate for Payer: UnitedHealthcare Community & State	$133.15
Rate for Payer: Wellpoint Medicaid Managed Care	$146.41

PLATE STR TUB 6 HOL ORTHOLOG

Facility

$12,510.00

Service Code	HCPCS C1713
Hospital Charge Code	270701111
Hospital Revenue Code	278
Min. Negotiated Rate	$1,876.50
Max. Negotiated Rate	$3,027.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,502.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,027.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,752.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,876.50

PLATE STR TUB 6 HOL ORTHOLOG

Facility

$12,510.00

Service Code	HCPCS C1713
Hospital Charge Code	270701111
Hospital Revenue Code	278
Min. Negotiated Rate	$301.49
Max. Negotiated Rate	$6,255.00
Rate for Payer: Aetna Commercial	$4,753.80
Rate for Payer: Aetna Medicare Advantage	$3,753.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,190.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,190.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,190.05
Rate for Payer: Cigna Commercial	$6,255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,027.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,752.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,876.50
Rate for Payer: UnitedHealthcare Community & State	$301.49
Rate for Payer: Wellpoint Medicaid Managed Care	$331.51

PLATE SUPCOND 90x255 118109010

Facility

$2,227.10

Hospital Charge Code	270632342
Hospital Revenue Code	278
Min. Negotiated Rate	$334.06
Max. Negotiated Rate	$538.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$489.96
Rate for Payer: Qualcare PPO/HMO/WC	$334.06

PLATE SUPCOND 90x255 118109010

Facility

$2,227.10

Hospital Charge Code	270632342
Hospital Revenue Code	278
Min. Negotiated Rate	$53.67
Max. Negotiated Rate	$1,113.55
Rate for Payer: Aetna Commercial	$846.30
Rate for Payer: Aetna Medicare Advantage	$668.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.91
Rate for Payer: Cigna Commercial	$1,113.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$489.96
Rate for Payer: Qualcare PPO/HMO/WC	$334.06
Rate for Payer: UnitedHealthcare Community & State	$53.67
Rate for Payer: Wellpoint Medicaid Managed Care	$59.02

PLATE SUPPORT SINUS TARSI RT M

Facility

$5,981.25

Service Code	HCPCS C1713
Hospital Charge Code	270701521
Hospital Revenue Code	278
Min. Negotiated Rate	$144.15
Max. Negotiated Rate	$2,990.62
Rate for Payer: Aetna Commercial	$2,272.88
Rate for Payer: Aetna Medicare Advantage	$1,794.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,525.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,525.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,525.22
Rate for Payer: Cigna Commercial	$2,990.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,315.88
Rate for Payer: Qualcare PPO/HMO/WC	$897.19
Rate for Payer: UnitedHealthcare Community & State	$144.15
Rate for Payer: Wellpoint Medicaid Managed Care	$158.50

PLATE SUPPORT SINUS TARSI RT M

Facility

$5,981.25

Service Code	HCPCS C1713
Hospital Charge Code	270701521
Hospital Revenue Code	278
Min. Negotiated Rate	$897.19
Max. Negotiated Rate	$1,447.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,315.88
Rate for Payer: Qualcare PPO/HMO/WC	$897.19

Know your out-of-pocket cost for care.

All Charges