Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SYN CLVRLF 6H 136 24186

Facility

$1,243.25

Hospital Charge Code	270624542
Hospital Revenue Code	278
Min. Negotiated Rate	$29.96
Max. Negotiated Rate	$621.62
Rate for Payer: Aetna Commercial	$472.44
Rate for Payer: Aetna Medicare Advantage	$372.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.03
Rate for Payer: Cigna Commercial	$621.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.51
Rate for Payer: Qualcare PPO/HMO/WC	$186.49
Rate for Payer: UnitedHealthcare Community & State	$29.96
Rate for Payer: Wellpoint Medicaid Managed Care	$32.95

PLATE SYN CLVRLF 6H 136 24186

Facility

$1,243.25

Hospital Charge Code	270624542
Hospital Revenue Code	278
Min. Negotiated Rate	$186.49
Max. Negotiated Rate	$300.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.51
Rate for Payer: Qualcare PPO/HMO/WC	$186.49

PLATE SYN CLVRLF TT 3H

Facility

$522.45

Hospital Charge Code	270603396
Hospital Revenue Code	278
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$261.23
Rate for Payer: Aetna Commercial	$198.53
Rate for Payer: Aetna Medicare Advantage	$156.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.22
Rate for Payer: Cigna Commercial	$261.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.94
Rate for Payer: Qualcare PPO/HMO/WC	$78.37
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.84

PLATE SYN CLVRLF TT 3H

Facility

$522.45

Hospital Charge Code	270603396
Hospital Revenue Code	278
Min. Negotiated Rate	$78.37
Max. Negotiated Rate	$126.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.94
Rate for Payer: Qualcare PPO/HMO/WC	$78.37

PLATE SYN CLVRLF TT 4H

Facility

$544.85

Hospital Charge Code	270603397
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$131.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

PLATE SYN CLVRLF TT 4H

Facility

$544.85

Hospital Charge Code	270603397
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$207.04
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

PLATE SYN CLVRLF TT 4H

Facility

$1,334.45

Hospital Charge Code	270604062
Hospital Revenue Code	278
Min. Negotiated Rate	$32.16
Max. Negotiated Rate	$667.23
Rate for Payer: Aetna Commercial	$507.09
Rate for Payer: Aetna Medicare Advantage	$400.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.28
Rate for Payer: Cigna Commercial	$667.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.58
Rate for Payer: Qualcare PPO/HMO/WC	$200.17
Rate for Payer: UnitedHealthcare Community & State	$32.16
Rate for Payer: Wellpoint Medicaid Managed Care	$35.36

PLATE SYN CLVRLF TT 4H

Facility

$1,334.45

Hospital Charge Code	270604062
Hospital Revenue Code	278
Min. Negotiated Rate	$200.17
Max. Negotiated Rate	$322.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.58
Rate for Payer: Qualcare PPO/HMO/WC	$200.17

PLATE SYN DBL Y 1.3 421068

Facility

$639.25

Hospital Charge Code	270626842
Hospital Revenue Code	278
Min. Negotiated Rate	$95.89
Max. Negotiated Rate	$154.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$140.63
Rate for Payer: Qualcare PPO/HMO/WC	$95.89

PLATE SYN DBL Y 1.3 421068

Facility

$639.25

Hospital Charge Code	270626842
Hospital Revenue Code	278
Min. Negotiated Rate	$15.41
Max. Negotiated Rate	$319.62
Rate for Payer: Aetna Commercial	$242.91
Rate for Payer: Aetna Medicare Advantage	$191.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.01
Rate for Payer: Cigna Commercial	$319.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$140.63
Rate for Payer: Qualcare PPO/HMO/WC	$95.89
Rate for Payer: UnitedHealthcare Community & State	$15.41
Rate for Payer: Wellpoint Medicaid Managed Care	$16.94

PLATE SYNDE LAT RT101MM ORTLCK

Facility

$2,325.00

Hospital Charge Code	270701059
Hospital Revenue Code	278
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$56.03
Rate for Payer: Wellpoint Medicaid Managed Care	$61.61

PLATE SYNDE LAT RT101MM ORTLCK

Facility

$2,325.00

Hospital Charge Code	270701059
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

PLATE SYN H 1.5MM

Facility

$558.45

Hospital Charge Code	270604350
Hospital Revenue Code	278
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$135.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.86
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

PLATE SYN H 1.5MM

Facility

$558.45

Hospital Charge Code	270604350
Hospital Revenue Code	278
Min. Negotiated Rate	$13.46
Max. Negotiated Rate	$279.23
Rate for Payer: Aetna Commercial	$212.21
Rate for Payer: Aetna Medicare Advantage	$167.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.40
Rate for Payer: Cigna Commercial	$279.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.86
Rate for Payer: Qualcare PPO/HMO/WC	$83.77
Rate for Payer: UnitedHealthcare Community & State	$13.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

PLATE SYN H 2.0MM

Facility

$558.45

Hospital Charge Code	270604349
Hospital Revenue Code	278
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$135.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.86
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

PLATE SYN H 2.0MM

Facility

$558.45

Hospital Charge Code	270604349
Hospital Revenue Code	278
Min. Negotiated Rate	$13.46
Max. Negotiated Rate	$279.23
Rate for Payer: Aetna Commercial	$212.21
Rate for Payer: Aetna Medicare Advantage	$167.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.40
Rate for Payer: Cigna Commercial	$279.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.86
Rate for Payer: Qualcare PPO/HMO/WC	$83.77
Rate for Payer: UnitedHealthcare Community & State	$13.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

PLATE SYN L 1.3 421.53

Facility

$644.00

Hospital Charge Code	270626841
Hospital Revenue Code	278
Min. Negotiated Rate	$15.52
Max. Negotiated Rate	$322.00
Rate for Payer: Aetna Commercial	$244.72
Rate for Payer: Aetna Medicare Advantage	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.22
Rate for Payer: Cigna Commercial	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.68
Rate for Payer: Qualcare PPO/HMO/WC	$96.60
Rate for Payer: UnitedHealthcare Community & State	$15.52
Rate for Payer: Wellpoint Medicaid Managed Care	$17.07

PLATE SYN L 1.3 421.53

Facility

$644.00

Hospital Charge Code	270626841
Hospital Revenue Code	278
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$155.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.68
Rate for Payer: Qualcare PPO/HMO/WC	$96.60

PLATE SYN LC TT 3.5 2 423.52

Facility

$608.85

Hospital Charge Code	270604044
Hospital Revenue Code	278
Min. Negotiated Rate	$91.33
Max. Negotiated Rate	$147.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.33

PLATE SYN LC TT 3.5 2 423.52

Facility

$608.85

Hospital Charge Code	270604044
Hospital Revenue Code	278
Min. Negotiated Rate	$14.67
Max. Negotiated Rate	$304.43
Rate for Payer: Aetna Commercial	$231.36
Rate for Payer: Aetna Medicare Advantage	$182.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.26
Rate for Payer: Cigna Commercial	$304.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.33
Rate for Payer: UnitedHealthcare Community & State	$14.67
Rate for Payer: Wellpoint Medicaid Managed Care	$16.13

PLATE SYN LC TT 3.5 3H 423.53

Facility

$530.45

Hospital Charge Code	270603338
Hospital Revenue Code	278
Min. Negotiated Rate	$79.57
Max. Negotiated Rate	$128.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57

PLATE SYN LC TT 3.5 3H 423.53

Facility

$530.45

Hospital Charge Code	270603338
Hospital Revenue Code	278
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$265.23
Rate for Payer: Aetna Commercial	$201.57
Rate for Payer: Aetna Medicare Advantage	$159.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.26
Rate for Payer: Cigna Commercial	$265.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57
Rate for Payer: UnitedHealthcare Community & State	$12.78
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

PLATE SYN LC TT 3.5 4H 423.54

Facility

$369.65

Hospital Charge Code	270603339
Hospital Revenue Code	278
Min. Negotiated Rate	$8.91
Max. Negotiated Rate	$184.82
Rate for Payer: Aetna Commercial	$140.47
Rate for Payer: Aetna Medicare Advantage	$110.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.26
Rate for Payer: Cigna Commercial	$184.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.32
Rate for Payer: Qualcare PPO/HMO/WC	$55.45
Rate for Payer: UnitedHealthcare Community & State	$8.91
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

PLATE SYN LC TT 3.5 4H 423.54

Facility

$369.65

Hospital Charge Code	270603339
Hospital Revenue Code	278
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$89.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.32
Rate for Payer: Qualcare PPO/HMO/WC	$55.45

PLATE SYN LC TT 3.5 4H 423.54*

Facility

$681.00

Hospital Charge Code	27060339
Hospital Revenue Code	274
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$340.50
Rate for Payer: Aetna Commercial	$258.78
Rate for Payer: Aetna Medicare Advantage	$204.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.66
Rate for Payer: Cigna Commercial	$340.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$149.82
Rate for Payer: Qualcare PPO/HMO/WC	$102.15
Rate for Payer: UnitedHealthcare Community & State	$16.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.05

Know your out-of-pocket cost for care.

All Charges