Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SYN SM T RT ANG H4-S 6H

Facility

$607.25

Hospital Charge Code	270604312
Hospital Revenue Code	278
Min. Negotiated Rate	$14.63
Max. Negotiated Rate	$303.62
Rate for Payer: Aetna Commercial	$230.75
Rate for Payer: Aetna Medicare Advantage	$182.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.85
Rate for Payer: Cigna Commercial	$303.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.59
Rate for Payer: Qualcare PPO/HMO/WC	$91.09
Rate for Payer: UnitedHealthcare Community & State	$14.63
Rate for Payer: Wellpoint Medicaid Managed Care	$16.09

PLATE SYN ST 1.5MM 20H

Facility

$783.25

Hospital Charge Code	270604333
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$189.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.31
Rate for Payer: Qualcare PPO/HMO/WC	$117.49

PLATE SYN ST 1.5MM 20H

Facility

$783.25

Hospital Charge Code	270604333
Hospital Revenue Code	278
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$391.62
Rate for Payer: Aetna Commercial	$297.63
Rate for Payer: Aetna Medicare Advantage	$234.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.73
Rate for Payer: Cigna Commercial	$391.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.31
Rate for Payer: Qualcare PPO/HMO/WC	$117.49
Rate for Payer: UnitedHealthcare Community & State	$18.88
Rate for Payer: Wellpoint Medicaid Managed Care	$20.76

PLATE SYN ST 2.0MM 20H

Facility

$783.25

Hospital Charge Code	270604331
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$189.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.31
Rate for Payer: Qualcare PPO/HMO/WC	$117.49

PLATE SYN ST 2.0MM 20H

Facility

$783.25

Hospital Charge Code	270604331
Hospital Revenue Code	278
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$391.62
Rate for Payer: Aetna Commercial	$297.63
Rate for Payer: Aetna Medicare Advantage	$234.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.73
Rate for Payer: Cigna Commercial	$391.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.31
Rate for Payer: Qualcare PPO/HMO/WC	$117.49
Rate for Payer: UnitedHealthcare Community & State	$18.88
Rate for Payer: Wellpoint Medicaid Managed Care	$20.76

PLATE SYN ST 2.0MM 3H

Facility

$192.85

Hospital Charge Code	270604327
Hospital Revenue Code	278
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$46.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.43
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

PLATE SYN ST 2.0MM 3H

Facility

$192.85

Hospital Charge Code	270604327
Hospital Revenue Code	278
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$96.42
Rate for Payer: Aetna Commercial	$73.28
Rate for Payer: Aetna Medicare Advantage	$57.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.18
Rate for Payer: Cigna Commercial	$96.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.43
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Community & State	$4.65
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

PLATE SYN ST 2.0MM 5H

Facility

$226.45

Hospital Charge Code	270604329
Hospital Revenue Code	278
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$113.22
Rate for Payer: Aetna Commercial	$86.05
Rate for Payer: Aetna Medicare Advantage	$67.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$113.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.82
Rate for Payer: Qualcare PPO/HMO/WC	$33.97
Rate for Payer: UnitedHealthcare Community & State	$5.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

PLATE SYN ST 2.0MM 5H

Facility

$226.45

Hospital Charge Code	270604329
Hospital Revenue Code	278
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$54.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$49.82
Rate for Payer: Qualcare PPO/HMO/WC	$33.97

PLATE SYN ST 2.0MM 6H

Facility

$248.85

Hospital Charge Code	270604330
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$94.56
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.33
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

PLATE SYN ST 2.0MM 6H

Facility

$248.85

Hospital Charge Code	270604330
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$60.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

PLATE SYN T 1.5MM H3-S 9H***

Facility

$278.00

Hospital Charge Code	270604336
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 SYN T 1.5MM H3-S 9H***

Facility

$278.00

Hospital Charge Code	270604336
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 SYN T 1.5MM H4-S 9H***

Facility

$370.00

Hospital Charge Code	270604337
Hospital Revenue Code	274
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

PLATE SYN T 1.5MM H4-S 9H***

Facility

$370.00

Hospital Charge Code	270604337
Hospital Revenue Code	274
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

PLATE SYN T H3-S 2.0MM 9H

Facility

$705.65

Hospital Charge Code	270604334
Hospital Revenue Code	278
Min. Negotiated Rate	$105.85
Max. Negotiated Rate	$170.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.24
Rate for Payer: Qualcare PPO/HMO/WC	$105.85

PLATE SYN T H3-S 2.0MM 9H

Facility

$705.65

Hospital Charge Code	270604334
Hospital Revenue Code	278
Min. Negotiated Rate	$17.01
Max. Negotiated Rate	$352.82
Rate for Payer: Aetna Commercial	$268.15
Rate for Payer: Aetna Medicare Advantage	$211.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.94
Rate for Payer: Cigna Commercial	$352.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.24
Rate for Payer: Qualcare PPO/HMO/WC	$105.85
Rate for Payer: UnitedHealthcare Community & State	$17.01
Rate for Payer: Wellpoint Medicaid Managed Care	$18.70

PLATE SYN T H4-S 2.0MM 9H

Facility

$996.85

Hospital Charge Code	270604335
Hospital Revenue Code	278
Min. Negotiated Rate	$149.53
Max. Negotiated Rate	$241.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$219.31
Rate for Payer: Qualcare PPO/HMO/WC	$149.53

PLATE SYN T H4-S 2.0MM 9H

Facility

$996.85

Hospital Charge Code	270604335
Hospital Revenue Code	278
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$498.43
Rate for Payer: Aetna Commercial	$378.80
Rate for Payer: Aetna Medicare Advantage	$299.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.20
Rate for Payer: Cigna Commercial	$498.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$219.31
Rate for Payer: Qualcare PPO/HMO/WC	$149.53
Rate for Payer: UnitedHealthcare Community & State	$24.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.42

PLATE SYN TIB 6H L 240006S

Facility

$3,208.85

Hospital Charge Code	270627313
Hospital Revenue Code	278
Min. Negotiated Rate	$77.33
Max. Negotiated Rate	$1,604.42
Rate for Payer: Aetna Commercial	$1,219.36
Rate for Payer: Aetna Medicare Advantage	$962.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$818.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$818.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$641.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$818.26
Rate for Payer: Cigna Commercial	$1,604.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$776.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$705.95
Rate for Payer: Qualcare PPO/HMO/WC	$481.33
Rate for Payer: UnitedHealthcare Community & State	$77.33
Rate for Payer: Wellpoint Medicaid Managed Care	$85.03

PLATE SYN TIB 6H L 240006S

Facility

$3,208.85

Hospital Charge Code	270627313
Hospital Revenue Code	278
Min. Negotiated Rate	$481.33
Max. Negotiated Rate	$776.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$641.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$776.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$705.95
Rate for Payer: Qualcare PPO/HMO/WC	$481.33

PLATE SYN TT MESH 38X53 421001

Facility

$3,182.45

Hospital Charge Code	270621200
Hospital Revenue Code	278
Min. Negotiated Rate	$477.37
Max. Negotiated Rate	$770.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$636.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$700.14
Rate for Payer: Qualcare PPO/HMO/WC	$477.37

PLATE SYN TT MESH 38X53 421001

Facility

$3,182.45

Hospital Charge Code	270621200
Hospital Revenue Code	278
Min. Negotiated Rate	$76.70
Max. Negotiated Rate	$1,591.22
Rate for Payer: Aetna Commercial	$1,209.33
Rate for Payer: Aetna Medicare Advantage	$954.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$811.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$811.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$636.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$811.52
Rate for Payer: Cigna Commercial	$1,591.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$700.14
Rate for Payer: Qualcare PPO/HMO/WC	$477.37
Rate for Payer: UnitedHealthcare Community & State	$76.70
Rate for Payer: Wellpoint Medicaid Managed Care	$84.33

PLATE SYST PLANTAR PARATROOPER

Facility

$4,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700495
Hospital Revenue Code	278
Min. Negotiated Rate	$113.87
Max. Negotiated Rate	$2,362.50
Rate for Payer: Aetna Commercial	$1,795.50
Rate for Payer: Aetna Medicare Advantage	$1,417.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,204.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,204.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,204.88
Rate for Payer: Cigna Commercial	$2,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,039.50
Rate for Payer: Qualcare PPO/HMO/WC	$708.75
Rate for Payer: UnitedHealthcare Community & State	$113.87
Rate for Payer: Wellpoint Medicaid Managed Care	$125.21

PLATE SYST PLANTAR PARATROOPER

Facility

$4,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700495
Hospital Revenue Code	278
Min. Negotiated Rate	$708.75
Max. Negotiated Rate	$1,143.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,039.50
Rate for Payer: Qualcare PPO/HMO/WC	$708.75

Know your out-of-pocket cost for care.

All Charges