Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TIBI 8HOLE DIST LT 26158

Facility

$5,600.00

Hospital Charge Code	270640152
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,232.00
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

PLATE TIBI 8HOLE DIST LT 26158

Facility

$5,600.00

Hospital Charge Code	270640152
Hospital Revenue Code	278
Min. Negotiated Rate	$134.96
Max. Negotiated Rate	$2,800.00
Rate for Payer: Aetna Commercial	$2,128.00
Rate for Payer: Aetna Medicare Advantage	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,428.00
Rate for Payer: Cigna Commercial	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,232.00
Rate for Payer: Qualcare PPO/HMO/WC	$840.00
Rate for Payer: UnitedHealthcare Community & State	$134.96
Rate for Payer: Wellpoint Medicaid Managed Care	$148.40

PLATE TIBIA 10 HOLE DISTAL

Facility

$712.40

Service Code	HCPCS C1713
Hospital Charge Code	270689576
Hospital Revenue Code	278
Min. Negotiated Rate	$17.17
Max. Negotiated Rate	$356.20
Rate for Payer: Aetna Commercial	$270.71
Rate for Payer: Aetna Medicare Advantage	$213.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.66
Rate for Payer: Cigna Commercial	$356.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.73
Rate for Payer: Qualcare PPO/HMO/WC	$106.86
Rate for Payer: UnitedHealthcare Community & State	$17.17
Rate for Payer: Wellpoint Medicaid Managed Care	$18.88

PLATE TIBIA 10 HOLE DISTAL

Facility

$712.40

Service Code	HCPCS C1713
Hospital Charge Code	270689576
Hospital Revenue Code	278
Min. Negotiated Rate	$106.86
Max. Negotiated Rate	$172.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.73
Rate for Payer: Qualcare PPO/HMO/WC	$106.86

PLATE TIBIA 12 HOLES 250MM

Facility

$9,549.00

Hospital Charge Code	270670452
Hospital Revenue Code	278
Min. Negotiated Rate	$1,432.35
Max. Negotiated Rate	$2,310.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,909.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,310.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,100.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.35

PLATE TIBIA 12 HOLES 250MM

Facility

$9,549.00

Hospital Charge Code	270670452
Hospital Revenue Code	278
Min. Negotiated Rate	$230.13
Max. Negotiated Rate	$4,774.50
Rate for Payer: Aetna Commercial	$3,628.62
Rate for Payer: Aetna Medicare Advantage	$2,864.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,434.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,434.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,909.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,434.99
Rate for Payer: Cigna Commercial	$4,774.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,310.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,100.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.35
Rate for Payer: UnitedHealthcare Community & State	$230.13
Rate for Payer: Wellpoint Medicaid Managed Care	$253.05

PLATE TIBIA 3.5MM 6H RT

Facility

$4,937.80

Service Code	HCPCS C1713
Hospital Charge Code	270651725
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$2,468.90
Rate for Payer: Aetna Commercial	$1,876.36
Rate for Payer: Aetna Medicare Advantage	$1,481.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.14
Rate for Payer: Cigna Commercial	$2,468.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,086.32
Rate for Payer: Qualcare PPO/HMO/WC	$740.67
Rate for Payer: UnitedHealthcare Community & State	$119.00
Rate for Payer: Wellpoint Medicaid Managed Care	$130.85

PLATE TIBIA 3.5MM 6H RT

Facility

$4,937.80

Service Code	HCPCS C1713
Hospital Charge Code	270651725
Hospital Revenue Code	278
Min. Negotiated Rate	$740.67
Max. Negotiated Rate	$1,194.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,086.32
Rate for Payer: Qualcare PPO/HMO/WC	$740.67

PLATE TIBIA 3.5MM 8H RT

Facility

$5,098.50

Service Code	HCPCS C1713
Hospital Charge Code	270651849
Hospital Revenue Code	278
Min. Negotiated Rate	$122.87
Max. Negotiated Rate	$2,549.25
Rate for Payer: Aetna Commercial	$1,937.43
Rate for Payer: Aetna Medicare Advantage	$1,529.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.12
Rate for Payer: Cigna Commercial	$2,549.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,121.67
Rate for Payer: Qualcare PPO/HMO/WC	$764.77
Rate for Payer: UnitedHealthcare Community & State	$122.87
Rate for Payer: Wellpoint Medicaid Managed Care	$135.11

PLATE TIBIA 3.5MM 8H RT

Facility

$5,098.50

Service Code	HCPCS C1713
Hospital Charge Code	270651849
Hospital Revenue Code	278
Min. Negotiated Rate	$764.77
Max. Negotiated Rate	$1,233.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,121.67
Rate for Payer: Qualcare PPO/HMO/WC	$764.77

PLATE TIBIA 4.5MM 4H LT

Facility

$6,037.85

Service Code	HCPCS C1713
Hospital Charge Code	270637030
Hospital Revenue Code	278
Min. Negotiated Rate	$905.68
Max. Negotiated Rate	$1,461.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,328.33
Rate for Payer: Qualcare PPO/HMO/WC	$905.68

PLATE TIBIA 4.5MM 4H LT

Facility

$6,037.85

Service Code	HCPCS C1713
Hospital Charge Code	270637030
Hospital Revenue Code	278
Min. Negotiated Rate	$145.51
Max. Negotiated Rate	$3,018.93
Rate for Payer: Aetna Commercial	$2,294.38
Rate for Payer: Aetna Medicare Advantage	$1,811.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,539.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,539.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,539.65
Rate for Payer: Cigna Commercial	$3,018.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,328.33
Rate for Payer: Qualcare PPO/HMO/WC	$905.68
Rate for Payer: UnitedHealthcare Community & State	$145.51
Rate for Payer: Wellpoint Medicaid Managed Care	$160.00

PLATE TIBIA 4.5MM 8H LT ST

Facility

$5,280.80

Service Code	HCPCS C1713
Hospital Charge Code	270646083
Hospital Revenue Code	278
Min. Negotiated Rate	$792.12
Max. Negotiated Rate	$1,277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.78
Rate for Payer: Qualcare PPO/HMO/WC	$792.12

PLATE TIBIA 4.5MM 8H LT ST

Facility

$5,280.80

Service Code	HCPCS C1713
Hospital Charge Code	270646083
Hospital Revenue Code	278
Min. Negotiated Rate	$127.27
Max. Negotiated Rate	$2,640.40
Rate for Payer: Aetna Commercial	$2,006.70
Rate for Payer: Aetna Medicare Advantage	$1,584.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.60
Rate for Payer: Cigna Commercial	$2,640.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,161.78
Rate for Payer: Qualcare PPO/HMO/WC	$792.12
Rate for Payer: UnitedHealthcare Community & State	$127.27
Rate for Payer: Wellpoint Medicaid Managed Care	$139.94

PLATE TIBIA 4.5MM 8H RT

Facility

$6,183.10

Service Code	HCPCS C1713
Hospital Charge Code	270628206
Hospital Revenue Code	278
Min. Negotiated Rate	$149.01
Max. Negotiated Rate	$3,091.55
Rate for Payer: Aetna Commercial	$2,349.58
Rate for Payer: Aetna Medicare Advantage	$1,854.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,576.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,576.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,576.69
Rate for Payer: Cigna Commercial	$3,091.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,496.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,360.28
Rate for Payer: Qualcare PPO/HMO/WC	$927.47
Rate for Payer: UnitedHealthcare Community & State	$149.01
Rate for Payer: Wellpoint Medicaid Managed Care	$163.85

PLATE TIBIA 4.5MM 8H RT

Facility

$6,183.10

Service Code	HCPCS C1713
Hospital Charge Code	270628206
Hospital Revenue Code	278
Min. Negotiated Rate	$927.47
Max. Negotiated Rate	$1,496.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,496.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,360.28
Rate for Payer: Qualcare PPO/HMO/WC	$927.47

PLATE TIBIA 4.5x226MM 12H RT

Facility

$6,322.15

Hospital Charge Code	270661909
Hospital Revenue Code	278
Min. Negotiated Rate	$152.36
Max. Negotiated Rate	$3,161.07
Rate for Payer: Aetna Commercial	$2,402.42
Rate for Payer: Aetna Medicare Advantage	$1,896.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,612.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,612.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,264.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,612.15
Rate for Payer: Cigna Commercial	$3,161.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,390.87
Rate for Payer: Qualcare PPO/HMO/WC	$948.32
Rate for Payer: UnitedHealthcare Community & State	$152.36
Rate for Payer: Wellpoint Medicaid Managed Care	$167.54

PLATE TIBIA 4.5x226MM 12H RT

Facility

$6,322.15

Hospital Charge Code	270661909
Hospital Revenue Code	278
Min. Negotiated Rate	$948.32
Max. Negotiated Rate	$1,529.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,264.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,390.87
Rate for Payer: Qualcare PPO/HMO/WC	$948.32

PLATE TIBIA 4.5x262MM 14H LT

Facility

$6,390.10

Hospital Charge Code	270661914
Hospital Revenue Code	278
Min. Negotiated Rate	$154.00
Max. Negotiated Rate	$3,195.05
Rate for Payer: Aetna Commercial	$2,428.24
Rate for Payer: Aetna Medicare Advantage	$1,917.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,629.48
Rate for Payer: Cigna Commercial	$3,195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,405.82
Rate for Payer: Qualcare PPO/HMO/WC	$958.51
Rate for Payer: UnitedHealthcare Community & State	$154.00
Rate for Payer: Wellpoint Medicaid Managed Care	$169.34

PLATE TIBIA 4.5x262MM 14H LT

Facility

$6,390.10

Hospital Charge Code	270661914
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$1,546.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,405.82
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x262MM 14H RT

Facility

$6,390.10

Hospital Charge Code	270661911
Hospital Revenue Code	278
Min. Negotiated Rate	$154.00
Max. Negotiated Rate	$3,195.05
Rate for Payer: Aetna Commercial	$2,428.24
Rate for Payer: Aetna Medicare Advantage	$1,917.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,629.48
Rate for Payer: Cigna Commercial	$3,195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,405.82
Rate for Payer: Qualcare PPO/HMO/WC	$958.51
Rate for Payer: UnitedHealthcare Community & State	$154.00
Rate for Payer: Wellpoint Medicaid Managed Care	$169.34

PLATE TIBIA 4.5x262MM 14H RT

Facility

$6,390.10

Hospital Charge Code	270661911
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$1,546.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,405.82
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x82MM 4H LT ST

Facility

$6,244.90

Hospital Charge Code	270665855
Hospital Revenue Code	278
Min. Negotiated Rate	$150.50
Max. Negotiated Rate	$3,122.45
Rate for Payer: Aetna Commercial	$2,373.06
Rate for Payer: Aetna Medicare Advantage	$1,873.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,592.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,592.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,248.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,592.45
Rate for Payer: Cigna Commercial	$3,122.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,511.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,373.88
Rate for Payer: Qualcare PPO/HMO/WC	$936.74
Rate for Payer: UnitedHealthcare Community & State	$150.50
Rate for Payer: Wellpoint Medicaid Managed Care	$165.49

PLATE TIBIA 4.5x82MM 4H LT ST

Facility

$6,244.90

Hospital Charge Code	270665855
Hospital Revenue Code	278
Min. Negotiated Rate	$936.74
Max. Negotiated Rate	$1,511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,248.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,511.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,373.88
Rate for Payer: Qualcare PPO/HMO/WC	$936.74

PLATE TIBIA 4 HOLE 3.5MM RIGHT

Facility

$6,440.00

Hospital Charge Code	270637379
Hospital Revenue Code	278
Min. Negotiated Rate	$966.00
Max. Negotiated Rate	$1,558.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,558.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,416.80
Rate for Payer: Qualcare PPO/HMO/WC	$966.00

Know your out-of-pocket cost for care.

All Charges