Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TITAN 1/3 TUBULAR 12HOLE

Facility

$343.00

Service Code	HCPCS C1713
Hospital Charge Code	270604060
Hospital Revenue Code	278
Min. Negotiated Rate	$8.27
Max. Negotiated Rate	$171.50
Rate for Payer: Aetna Commercial	$130.34
Rate for Payer: Aetna Medicare Advantage	$102.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.47
Rate for Payer: Cigna Commercial	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.46
Rate for Payer: Qualcare PPO/HMO/WC	$51.45
Rate for Payer: UnitedHealthcare Community & State	$8.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

PLATE TITAN 1/3 TUBULAR 12HOLE

Facility

$343.00

Service Code	HCPCS C1713
Hospital Charge Code	270604060
Hospital Revenue Code	278
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$83.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$75.46
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

PLATE TITAN 1/3 TUBULAR4HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603379
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$71.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.26
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

PLATE TITAN 1/3 TUBULAR4HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603379
Hospital Revenue Code	278
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$148.32
Rate for Payer: Aetna Commercial	$112.73
Rate for Payer: Aetna Medicare Advantage	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.65
Rate for Payer: Cigna Commercial	$148.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.26
Rate for Payer: Qualcare PPO/HMO/WC	$44.50
Rate for Payer: UnitedHealthcare Community & State	$7.15
Rate for Payer: Wellpoint Medicaid Managed Care	$7.86

PLATE TITAN 1/3 TUBULAR 5HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603380
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$71.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.26
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

PLATE TITAN 1/3 TUBULAR 5HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603380
Hospital Revenue Code	278
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$148.32
Rate for Payer: Aetna Commercial	$112.73
Rate for Payer: Aetna Medicare Advantage	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.65
Rate for Payer: Cigna Commercial	$148.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.26
Rate for Payer: Qualcare PPO/HMO/WC	$44.50
Rate for Payer: UnitedHealthcare Community & State	$7.15
Rate for Payer: Wellpoint Medicaid Managed Care	$7.86

PLATE TITAN 1/3 TUBULAR 7HOLE

Facility

$307.45

Service Code	HCPCS C1713
Hospital Charge Code	270603382
Hospital Revenue Code	278
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$153.72
Rate for Payer: Aetna Commercial	$116.83
Rate for Payer: Aetna Medicare Advantage	$92.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.40
Rate for Payer: Cigna Commercial	$153.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.64
Rate for Payer: Qualcare PPO/HMO/WC	$46.12
Rate for Payer: UnitedHealthcare Community & State	$7.41
Rate for Payer: Wellpoint Medicaid Managed Care	$8.15

PLATE TITAN 1/3 TUBULAR 7HOLE

Facility

$307.45

Service Code	HCPCS C1713
Hospital Charge Code	270603382
Hospital Revenue Code	278
Min. Negotiated Rate	$46.12
Max. Negotiated Rate	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.64
Rate for Payer: Qualcare PPO/HMO/WC	$46.12

PLATE TITAN 1/3 TUBULAR 9HOLE

Facility

$318.25

Service Code	HCPCS C1713
Hospital Charge Code	270603384
Hospital Revenue Code	278
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$159.12
Rate for Payer: Aetna Commercial	$120.94
Rate for Payer: Aetna Medicare Advantage	$95.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.15
Rate for Payer: Cigna Commercial	$159.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.02
Rate for Payer: Qualcare PPO/HMO/WC	$47.74
Rate for Payer: UnitedHealthcare Community & State	$7.67
Rate for Payer: Wellpoint Medicaid Managed Care	$8.43

PLATE TITAN 1/3 TUBULAR 9HOLE

Facility

$318.25

Service Code	HCPCS C1713
Hospital Charge Code	270603384
Hospital Revenue Code	278
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$77.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.02
Rate for Payer: Qualcare PPO/HMO/WC	$47.74

PLATE TITAN 1/4 TUBULAR 4HOLE

Facility

$562.40

Service Code	HCPCS C1713
Hospital Charge Code	270603409
Hospital Revenue Code	278
Min. Negotiated Rate	$84.36
Max. Negotiated Rate	$136.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.73
Rate for Payer: Qualcare PPO/HMO/WC	$84.36

PLATE TITAN 1/4 TUBULAR 4HOLE

Facility

$562.40

Service Code	HCPCS C1713
Hospital Charge Code	270603409
Hospital Revenue Code	278
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$281.20
Rate for Payer: Aetna Commercial	$213.71
Rate for Payer: Aetna Medicare Advantage	$168.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.41
Rate for Payer: Cigna Commercial	$281.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$123.73
Rate for Payer: Qualcare PPO/HMO/WC	$84.36
Rate for Payer: UnitedHealthcare Community & State	$13.55
Rate for Payer: Wellpoint Medicaid Managed Care	$14.90

PLATE TITAN 1/4 TUBULAR 6HOLE

Facility

$726.15

Service Code	HCPCS C1713
Hospital Charge Code	270603411
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$363.07
Rate for Payer: Aetna Commercial	$275.94
Rate for Payer: Aetna Medicare Advantage	$217.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.17
Rate for Payer: Cigna Commercial	$363.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.92
Rate for Payer: UnitedHealthcare Community & State	$17.50
Rate for Payer: Wellpoint Medicaid Managed Care	$19.24

PLATE TITAN 1/4 TUBULAR 6HOLE

Facility

$726.15

Service Code	HCPCS C1713
Hospital Charge Code	270603411
Hospital Revenue Code	278
Min. Negotiated Rate	$108.92
Max. Negotiated Rate	$175.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.92

PLATE TITAN 2.7mm L OBLIQ.LEFT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603414
Hospital Revenue Code	278
Min. Negotiated Rate	$39.63
Max. Negotiated Rate	$63.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.12
Rate for Payer: Qualcare PPO/HMO/WC	$39.63

PLATE TITAN 2.7mm L OBLIQ.LEFT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603414
Hospital Revenue Code	278
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$132.10
Rate for Payer: Aetna Commercial	$100.40
Rate for Payer: Aetna Medicare Advantage	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.37
Rate for Payer: Cigna Commercial	$132.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.12
Rate for Payer: Qualcare PPO/HMO/WC	$39.63
Rate for Payer: UnitedHealthcare Community & State	$6.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.00

PLATE TITAN 2.7mm OBLIQ.RIGHT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603415
Hospital Revenue Code	278
Min. Negotiated Rate	$39.63
Max. Negotiated Rate	$63.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.12
Rate for Payer: Qualcare PPO/HMO/WC	$39.63

PLATE TITAN 2.7mm OBLIQ.RIGHT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603415
Hospital Revenue Code	278
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$132.10
Rate for Payer: Aetna Commercial	$100.40
Rate for Payer: Aetna Medicare Advantage	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.37
Rate for Payer: Cigna Commercial	$132.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$58.12
Rate for Payer: Qualcare PPO/HMO/WC	$39.63
Rate for Payer: UnitedHealthcare Community & State	$6.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.00

PLATE TITAN CALCANEAL 70mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603403
Hospital Revenue Code	278
Min. Negotiated Rate	$57.12
Max. Negotiated Rate	$1,185.03
Rate for Payer: Aetna Commercial	$900.62
Rate for Payer: Aetna Medicare Advantage	$711.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.36
Rate for Payer: Cigna Commercial	$1,185.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.41
Rate for Payer: Qualcare PPO/HMO/WC	$355.51
Rate for Payer: UnitedHealthcare Community & State	$57.12
Rate for Payer: Wellpoint Medicaid Managed Care	$62.81

PLATE TITAN CALCANEAL 70mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603403
Hospital Revenue Code	278
Min. Negotiated Rate	$355.51
Max. Negotiated Rate	$573.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.41
Rate for Payer: Qualcare PPO/HMO/WC	$355.51

PLATE TITAN CALCANEAL Y 87mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603404
Hospital Revenue Code	278
Min. Negotiated Rate	$355.51
Max. Negotiated Rate	$573.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.41
Rate for Payer: Qualcare PPO/HMO/WC	$355.51

PLATE TITAN CALCANEAL Y 87mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603404
Hospital Revenue Code	278
Min. Negotiated Rate	$57.12
Max. Negotiated Rate	$1,185.03
Rate for Payer: Aetna Commercial	$900.62
Rate for Payer: Aetna Medicare Advantage	$711.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.36
Rate for Payer: Cigna Commercial	$1,185.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.41
Rate for Payer: Qualcare PPO/HMO/WC	$355.51
Rate for Payer: UnitedHealthcare Community & State	$57.12
Rate for Payer: Wellpoint Medicaid Managed Care	$62.81

PLATE TITAN H 1.5mm

Facility

$905.35

Service Code	HCPCS C1713
Hospital Charge Code	270604102
Hospital Revenue Code	278
Min. Negotiated Rate	$135.80
Max. Negotiated Rate	$219.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.18
Rate for Payer: Qualcare PPO/HMO/WC	$135.80

PLATE TITAN H 1.5mm

Facility

$905.35

Service Code	HCPCS C1713
Hospital Charge Code	270604102
Hospital Revenue Code	278
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$452.68
Rate for Payer: Aetna Commercial	$344.03
Rate for Payer: Aetna Medicare Advantage	$271.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.86
Rate for Payer: Cigna Commercial	$452.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$199.18
Rate for Payer: Qualcare PPO/HMO/WC	$135.80
Rate for Payer: UnitedHealthcare Community & State	$21.82
Rate for Payer: Wellpoint Medicaid Managed Care	$23.99

PLATE TITAN H 2.0mm

Facility

$930.10

Service Code	HCPCS C1713
Hospital Charge Code	270603546
Hospital Revenue Code	278
Min. Negotiated Rate	$22.42
Max. Negotiated Rate	$465.05
Rate for Payer: Aetna Commercial	$353.44
Rate for Payer: Aetna Medicare Advantage	$279.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.18
Rate for Payer: Cigna Commercial	$465.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.62
Rate for Payer: Qualcare PPO/HMO/WC	$139.51
Rate for Payer: UnitedHealthcare Community & State	$22.42
Rate for Payer: Wellpoint Medicaid Managed Care	$24.65

Know your out-of-pocket cost for care.

All Charges