Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE T 12 HOLES

Facility

$2,240.25

Service Code	HCPCS C1713
Hospital Charge Code	270680075
Hospital Revenue Code	278
Min. Negotiated Rate	$53.99
Max. Negotiated Rate	$1,120.12
Rate for Payer: Aetna Commercial	$851.29
Rate for Payer: Aetna Medicare Advantage	$672.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$571.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$571.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$448.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$571.26
Rate for Payer: Cigna Commercial	$1,120.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$492.86
Rate for Payer: Qualcare PPO/HMO/WC	$336.04
Rate for Payer: UnitedHealthcare Community & State	$53.99
Rate for Payer: Wellpoint Medicaid Managed Care	$59.37

PLATE T 12 HOLES

Facility

$2,240.25

Service Code	HCPCS C1713
Hospital Charge Code	270680075
Hospital Revenue Code	278
Min. Negotiated Rate	$336.04
Max. Negotiated Rate	$542.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$448.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$492.86
Rate for Payer: Qualcare PPO/HMO/WC	$336.04

PLATE T 2.0 MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689801
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 T 2.0 MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689801
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 T 8-HOLE 2451-147-08

Facility

$924.00

Hospital Charge Code	270610446
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.28
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

PLATE T 8-HOLE 2451-147-08

Facility

$924.00

Hospital Charge Code	270610446
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$203.28
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Community & State	$22.27
Rate for Payer: Wellpoint Medicaid Managed Care	$24.49

PLATE T 8 HOLES/148MM

Facility

$2,020.85

Service Code	HCPCS C1713
Hospital Charge Code	270655717
Hospital Revenue Code	278
Min. Negotiated Rate	$303.13
Max. Negotiated Rate	$489.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$489.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$444.59
Rate for Payer: Qualcare PPO/HMO/WC	$303.13

PLATE T 8 HOLES/148MM

Facility

$2,020.85

Service Code	HCPCS C1713
Hospital Charge Code	270655717
Hospital Revenue Code	278
Min. Negotiated Rate	$48.70
Max. Negotiated Rate	$1,010.42
Rate for Payer: Aetna Commercial	$767.92
Rate for Payer: Aetna Medicare Advantage	$606.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.32
Rate for Payer: Cigna Commercial	$1,010.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$489.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$444.59
Rate for Payer: Qualcare PPO/HMO/WC	$303.13
Rate for Payer: UnitedHealthcare Community & State	$48.70
Rate for Payer: Wellpoint Medicaid Managed Care	$53.55

PLATE TACK

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270684668
Hospital Revenue Code	278
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 TACK

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	270669449
Hospital Revenue Code	278
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.60
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

PLATE TACK

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270684668
Hospital Revenue Code	278
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 TACK

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	270669449
Hospital Revenue Code	278
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$55.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.60
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

PLATE TARSI SUPPORT RT.MED

Facility

$5,981.25

Hospital Charge Code	270701494
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 TARSI SUPPORT RT.MED

Facility

$5,981.25

Hospital Charge Code	270701494
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

PLATE TEMP P.H

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270683198
Hospital Revenue Code	278
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 TEMP P.H

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270683198
Hospital Revenue Code	278
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 T-FUSION 2.4/2.7MM SHRT

Facility

$3,956.10

Service Code	HCPCS C1713
Hospital Charge Code	270683197
Hospital Revenue Code	278
Min. Negotiated Rate	$593.41
Max. Negotiated Rate	$957.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.34
Rate for Payer: Qualcare PPO/HMO/WC	$593.41

PLATE T-FUSION 2.4/2.7MM SHRT

Facility

$3,956.10

Service Code	HCPCS C1713
Hospital Charge Code	270683197
Hospital Revenue Code	278
Min. Negotiated Rate	$95.34
Max. Negotiated Rate	$1,978.05
Rate for Payer: Aetna Commercial	$1,503.32
Rate for Payer: Aetna Medicare Advantage	$1,186.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.81
Rate for Payer: Cigna Commercial	$1,978.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.34
Rate for Payer: Qualcare PPO/HMO/WC	$593.41
Rate for Payer: UnitedHealthcare Community & State	$95.34
Rate for Payer: Wellpoint Medicaid Managed Care	$104.84

PLATE T-FUSION 2.4/2.7MM STD

Facility

$3,822.00

Service Code	HCPCS C1713
Hospital Charge Code	270677232
Hospital Revenue Code	278
Min. Negotiated Rate	$573.30
Max. Negotiated Rate	$924.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$764.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$924.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$840.84
Rate for Payer: Qualcare PPO/HMO/WC	$573.30

PLATE T-FUSION 2.4/2.7MM STD

Facility

$3,822.00

Service Code	HCPCS C1713
Hospital Charge Code	270677232
Hospital Revenue Code	278
Min. Negotiated Rate	$92.11
Max. Negotiated Rate	$1,911.00
Rate for Payer: Aetna Commercial	$1,452.36
Rate for Payer: Aetna Medicare Advantage	$1,146.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$974.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$974.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$764.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$974.61
Rate for Payer: Cigna Commercial	$1,911.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$924.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$840.84
Rate for Payer: Qualcare PPO/HMO/WC	$573.30
Rate for Payer: UnitedHealthcare Community & State	$92.11
Rate for Payer: Wellpoint Medicaid Managed Care	$101.28

PLATE TFUSION 2.4/2.7MM STD 2H

Facility

$3,729.65

Service Code	HCPCS C1713
Hospital Charge Code	270680182
Hospital Revenue Code	278
Min. Negotiated Rate	$89.88
Max. Negotiated Rate	$1,864.83
Rate for Payer: Aetna Commercial	$1,417.27
Rate for Payer: Aetna Medicare Advantage	$1,118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$951.06
Rate for Payer: Cigna Commercial	$1,864.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$820.52
Rate for Payer: Qualcare PPO/HMO/WC	$559.45
Rate for Payer: UnitedHealthcare Community & State	$89.88
Rate for Payer: Wellpoint Medicaid Managed Care	$98.84

PLATE TFUSION 2.4/2.7MM STD 2H

Facility

$3,729.65

Service Code	HCPCS C1713
Hospital Charge Code	270680182
Hospital Revenue Code	278
Min. Negotiated Rate	$559.45
Max. Negotiated Rate	$902.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$820.52
Rate for Payer: Qualcare PPO/HMO/WC	$559.45

PLATE THIRD TUBULAR LCK SS 10H

Facility

$1,400.00

Hospital Charge Code	270664484
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

PLATE THIRD TUBULAR LCK SS 10H

Facility

$1,400.00

Hospital Charge Code	270664484
Hospital Revenue Code	278
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Community & State	$33.74
Rate for Payer: Wellpoint Medicaid Managed Care	$37.10

PLATE THIRD TUBULAR LCK SS 12H

Facility

$1,500.00

Hospital Charge Code	270671906
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges