Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

3.5 LCP REC. PLATE

Facility

$1,890.50

Service Code	HCPCS C1713
Hospital Charge Code	270680935
Hospital Revenue Code	278
Min. Negotiated Rate	$283.57
Max. Negotiated Rate	$457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.91
Rate for Payer: Qualcare PPO/HMO/WC	$283.57

3.5 LCP VA PROXIMAL TIBIA PLAT

Facility

$7,687.90

Service Code	HCPCS C1713
Hospital Charge Code	270679036
Hospital Revenue Code	278
Min. Negotiated Rate	$185.28
Max. Negotiated Rate	$3,843.95
Rate for Payer: Aetna Commercial	$2,921.40
Rate for Payer: Aetna Medicare Advantage	$2,306.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,960.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,960.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,537.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,960.41
Rate for Payer: Cigna Commercial	$3,843.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,691.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,153.18
Rate for Payer: UnitedHealthcare Community & State	$185.28
Rate for Payer: Wellpoint Medicaid Managed Care	$203.73

3.5 LCP VA PROXIMAL TIBIA PLAT

Facility

$7,687.90

Service Code	HCPCS C1713
Hospital Charge Code	270679036
Hospital Revenue Code	278
Min. Negotiated Rate	$1,153.18
Max. Negotiated Rate	$1,860.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,537.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,691.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,153.18

3.5 LEFT OPEN WEDGE PLATE

Facility

$5,680.00

Hospital Charge Code	270656450
Hospital Revenue Code	278
Min. Negotiated Rate	$852.00
Max. Negotiated Rate	$1,374.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,374.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,249.60
Rate for Payer: Qualcare PPO/HMO/WC	$852.00

3.5 LEFT OPEN WEDGE PLATE

Facility

$5,680.00

Hospital Charge Code	270656450
Hospital Revenue Code	278
Min. Negotiated Rate	$136.89
Max. Negotiated Rate	$2,840.00
Rate for Payer: Aetna Commercial	$2,158.40
Rate for Payer: Aetna Medicare Advantage	$1,704.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,448.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,448.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,448.40
Rate for Payer: Cigna Commercial	$2,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,374.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,249.60
Rate for Payer: Qualcare PPO/HMO/WC	$852.00
Rate for Payer: UnitedHealthcare Community & State	$136.89
Rate for Payer: Wellpoint Medicaid Managed Care	$150.52

3.5 LOCKING 14MM

Facility

$480.25

Hospital Charge Code	270656883
Hospital Revenue Code	278
Min. Negotiated Rate	$72.04
Max. Negotiated Rate	$116.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.66
Rate for Payer: Qualcare PPO/HMO/WC	$72.04

3.5 LOCKING 14MM

Facility

$480.25

Hospital Charge Code	270656883
Hospital Revenue Code	278
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.12
Rate for Payer: Aetna Commercial	$182.50
Rate for Payer: Aetna Medicare Advantage	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.46
Rate for Payer: Cigna Commercial	$240.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.66
Rate for Payer: Qualcare PPO/HMO/WC	$72.04
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.73

3.5 LOCKING 18MM

Facility

$480.25

Service Code	HCPCS C1713
Hospital Charge Code	270656872
Hospital Revenue Code	278
Min. Negotiated Rate	$72.04
Max. Negotiated Rate	$116.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.66
Rate for Payer: Qualcare PPO/HMO/WC	$72.04

3.5 LOCKING 18MM

Facility

$480.25

Service Code	HCPCS C1713
Hospital Charge Code	270656872
Hospital Revenue Code	278
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.12
Rate for Payer: Aetna Commercial	$182.50
Rate for Payer: Aetna Medicare Advantage	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.46
Rate for Payer: Cigna Commercial	$240.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.66
Rate for Payer: Qualcare PPO/HMO/WC	$72.04
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.73

3.5 LOCKING SCREW 50MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270676134
Hospital Revenue Code	278
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

3.5 LOCKING SCREW 50MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270676134
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.64
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

3.5 LOCKING SCREW 56MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270676430
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

3.5 LOCKING SCREW 56MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270676430
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

3.5 LOCKINH 16MM

Facility

$1,440.75

Hospital Charge Code	270656884
Hospital Revenue Code	278
Min. Negotiated Rate	$34.72
Max. Negotiated Rate	$720.38
Rate for Payer: Aetna Commercial	$547.49
Rate for Payer: Aetna Medicare Advantage	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.39
Rate for Payer: Cigna Commercial	$720.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$316.96
Rate for Payer: Qualcare PPO/HMO/WC	$216.11
Rate for Payer: UnitedHealthcare Community & State	$34.72
Rate for Payer: Wellpoint Medicaid Managed Care	$38.18

3.5 LOCKINH 16MM

Facility

$1,440.75

Hospital Charge Code	270656884
Hospital Revenue Code	278
Min. Negotiated Rate	$216.11
Max. Negotiated Rate	$348.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$316.96
Rate for Payer: Qualcare PPO/HMO/WC	$216.11

3.5MM CNNLTD SCRW FUL THD 18MM

Facility

$909.95

Hospital Charge Code	270663173
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$454.98
Rate for Payer: Aetna Commercial	$345.78
Rate for Payer: Aetna Medicare Advantage	$272.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.04
Rate for Payer: Cigna Commercial	$454.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

3.5MM CNNLTD SCRW FUL THD 18MM

Facility

$909.95

Hospital Charge Code	270663173
Hospital Revenue Code	278
Min. Negotiated Rate	$136.49
Max. Negotiated Rate	$220.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49

3.5MM CNNLTD SCRW FUL THD 36MM

Facility

$909.95

Hospital Charge Code	270663174
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$454.98
Rate for Payer: Aetna Commercial	$345.78
Rate for Payer: Aetna Medicare Advantage	$272.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.04
Rate for Payer: Cigna Commercial	$454.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

3.5MM CNNLTD SCRW FUL THD 36MM

Facility

$909.95

Hospital Charge Code	270663174
Hospital Revenue Code	278
Min. Negotiated Rate	$136.49
Max. Negotiated Rate	$220.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49

3.5MM CNNLTD SCRW FUL THD 40MM

Facility

$909.95

Hospital Charge Code	270663175
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$454.98
Rate for Payer: Aetna Commercial	$345.78
Rate for Payer: Aetna Medicare Advantage	$272.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.04
Rate for Payer: Cigna Commercial	$454.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

3.5MM CNNLTD SCRW FUL THD 40MM

Facility

$909.95

Hospital Charge Code	270663175
Hospital Revenue Code	278
Min. Negotiated Rate	$136.49
Max. Negotiated Rate	$220.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49

3.5MM CNNLTD SCRW FUL THD 50MM

Facility

$909.95

Hospital Charge Code	270663176
Hospital Revenue Code	278
Min. Negotiated Rate	$136.49
Max. Negotiated Rate	$220.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49

3.5MM CNNLTD SCRW FUL THD 50MM

Facility

$909.95

Hospital Charge Code	270663176
Hospital Revenue Code	278
Min. Negotiated Rate	$21.93
Max. Negotiated Rate	$454.98
Rate for Payer: Aetna Commercial	$345.78
Rate for Payer: Aetna Medicare Advantage	$272.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.04
Rate for Payer: Cigna Commercial	$454.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$200.19
Rate for Payer: Qualcare PPO/HMO/WC	$136.49
Rate for Payer: UnitedHealthcare Community & State	$21.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.11

3.5MM CORTICAL SCREW SELF TAP

Facility

$165.00

Service Code	HCPCS C1713
Hospital Charge Code	270684873
Hospital Revenue Code	278
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$39.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

3.5MM CORTICAL SCREW SELF TAP

Facility

$165.00

Service Code	HCPCS C1713
Hospital Charge Code	270684873
Hospital Revenue Code	278
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$62.70
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

Know your out-of-pocket cost for care.

All Charges