Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VA-LCP 2.7/3.5x101MM 10H

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270675007
Hospital Revenue Code	278
Min. Negotiated Rate	$102.47
Max. Negotiated Rate	$2,125.93
Rate for Payer: Aetna Commercial	$1,615.70
Rate for Payer: Aetna Medicare Advantage	$1,275.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,084.22
Rate for Payer: Cigna Commercial	$2,125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.41
Rate for Payer: Qualcare PPO/HMO/WC	$637.78
Rate for Payer: UnitedHealthcare Community & State	$102.47
Rate for Payer: Wellpoint Medicaid Managed Care	$112.67

PLATE VA-LCP 2.7/3.5x101MM 10H

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270675007
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$1,028.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.41
Rate for Payer: Qualcare PPO/HMO/WC	$637.78

PLATE VA-LCP 2.7MM 3HOLE RIGHT

Facility

$3,324.00

Hospital Charge Code	270676460
Hospital Revenue Code	278
Min. Negotiated Rate	$498.60
Max. Negotiated Rate	$804.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$664.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.28
Rate for Payer: Qualcare PPO/HMO/WC	$498.60

PLATE VA-LCP 2.7MM 3HOLE RIGHT

Facility

$3,324.00

Hospital Charge Code	270676460
Hospital Revenue Code	278
Min. Negotiated Rate	$80.11
Max. Negotiated Rate	$1,662.00
Rate for Payer: Aetna Commercial	$1,263.12
Rate for Payer: Aetna Medicare Advantage	$997.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$664.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.62
Rate for Payer: Cigna Commercial	$1,662.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.28
Rate for Payer: Qualcare PPO/HMO/WC	$498.60
Rate for Payer: UnitedHealthcare Community & State	$80.11
Rate for Payer: Wellpoint Medicaid Managed Care	$88.09

PLATE VA-LCP 2.7MM 4HL LT STER

Facility

$3,898.80

Service Code	HCPCS C1713
Hospital Charge Code	270663830
Hospital Revenue Code	278
Min. Negotiated Rate	$584.82
Max. Negotiated Rate	$943.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$779.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$857.74
Rate for Payer: Qualcare PPO/HMO/WC	$584.82

PLATE VA-LCP 2.7MM 4HL LT STER

Facility

$3,898.80

Service Code	HCPCS C1713
Hospital Charge Code	270663830
Hospital Revenue Code	278
Min. Negotiated Rate	$93.96
Max. Negotiated Rate	$1,949.40
Rate for Payer: Aetna Commercial	$1,481.54
Rate for Payer: Aetna Medicare Advantage	$1,169.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$994.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$994.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$779.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$994.19
Rate for Payer: Cigna Commercial	$1,949.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$857.74
Rate for Payer: Qualcare PPO/HMO/WC	$584.82
Rate for Payer: UnitedHealthcare Community & State	$93.96
Rate for Payer: Wellpoint Medicaid Managed Care	$103.32

PLATE VA-LCP 2.7MM 4HOLE LEFT

Facility

$3,474.00

Service Code	HCPCS C1713
Hospital Charge Code	270676228
Hospital Revenue Code	278
Min. Negotiated Rate	$521.10
Max. Negotiated Rate	$840.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$694.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.28
Rate for Payer: Qualcare PPO/HMO/WC	$521.10

PLATE VA-LCP 2.7MM 4HOLE LEFT

Facility

$3,474.00

Service Code	HCPCS C1713
Hospital Charge Code	270676228
Hospital Revenue Code	278
Min. Negotiated Rate	$83.72
Max. Negotiated Rate	$1,737.00
Rate for Payer: Aetna Commercial	$1,320.12
Rate for Payer: Aetna Medicare Advantage	$1,042.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$885.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$885.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$694.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$885.87
Rate for Payer: Cigna Commercial	$1,737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.28
Rate for Payer: Qualcare PPO/HMO/WC	$521.10
Rate for Payer: UnitedHealthcare Community & State	$83.72
Rate for Payer: Wellpoint Medicaid Managed Care	$92.06

PLATE VA-LCP 2.7MM 5HOLE RIGHT

Facility

$3,757.45

Service Code	HCPCS C1713
Hospital Charge Code	270659119
Hospital Revenue Code	278
Min. Negotiated Rate	$90.55
Max. Negotiated Rate	$1,878.72
Rate for Payer: Aetna Commercial	$1,427.83
Rate for Payer: Aetna Medicare Advantage	$1,127.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$958.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$958.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$958.15
Rate for Payer: Cigna Commercial	$1,878.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$826.64
Rate for Payer: Qualcare PPO/HMO/WC	$563.62
Rate for Payer: UnitedHealthcare Community & State	$90.55
Rate for Payer: Wellpoint Medicaid Managed Care	$99.57

PLATE VA-LCP 2.7MM 5HOLE RIGHT

Facility

$3,757.45

Service Code	HCPCS C1713
Hospital Charge Code	270659119
Hospital Revenue Code	278
Min. Negotiated Rate	$563.62
Max. Negotiated Rate	$909.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$826.64
Rate for Payer: Qualcare PPO/HMO/WC	$563.62

PLATE VA-LCP 2.7MM 6H LT STER

Facility

$4,156.05

Service Code	HCPCS C1713
Hospital Charge Code	270675144
Hospital Revenue Code	278
Min. Negotiated Rate	$623.41
Max. Negotiated Rate	$1,005.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$831.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$914.33
Rate for Payer: Qualcare PPO/HMO/WC	$623.41

PLATE VA-LCP 2.7MM 6H LT STER

Facility

$4,156.05

Service Code	HCPCS C1713
Hospital Charge Code	270675144
Hospital Revenue Code	278
Min. Negotiated Rate	$100.16
Max. Negotiated Rate	$2,078.03
Rate for Payer: Aetna Commercial	$1,579.30
Rate for Payer: Aetna Medicare Advantage	$1,246.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,059.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,059.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$831.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,059.79
Rate for Payer: Cigna Commercial	$2,078.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$914.33
Rate for Payer: Qualcare PPO/HMO/WC	$623.41
Rate for Payer: UnitedHealthcare Community & State	$100.16
Rate for Payer: Wellpoint Medicaid Managed Care	$110.14

PLATE VA-LCP 2.7MM 6HOLE LEFT

Facility

$3,834.00

Hospital Charge Code	270676464
Hospital Revenue Code	278
Min. Negotiated Rate	$575.10
Max. Negotiated Rate	$927.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$843.48
Rate for Payer: Qualcare PPO/HMO/WC	$575.10

PLATE VA-LCP 2.7MM 6HOLE LEFT

Facility

$3,834.00

Hospital Charge Code	270676464
Hospital Revenue Code	278
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$1,917.00
Rate for Payer: Aetna Commercial	$1,456.92
Rate for Payer: Aetna Medicare Advantage	$1,150.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$977.67
Rate for Payer: Cigna Commercial	$1,917.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$843.48
Rate for Payer: Qualcare PPO/HMO/WC	$575.10
Rate for Payer: UnitedHealthcare Community & State	$92.40
Rate for Payer: Wellpoint Medicaid Managed Care	$101.60

PLATE VA-LCP 2.7MM 6HOLE RT

Facility

$3,834.00

Hospital Charge Code	270676463
Hospital Revenue Code	278
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$1,917.00
Rate for Payer: Aetna Commercial	$1,456.92
Rate for Payer: Aetna Medicare Advantage	$1,150.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$977.67
Rate for Payer: Cigna Commercial	$1,917.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$843.48
Rate for Payer: Qualcare PPO/HMO/WC	$575.10
Rate for Payer: UnitedHealthcare Community & State	$92.40
Rate for Payer: Wellpoint Medicaid Managed Care	$101.60

PLATE VA-LCP 2.7MM 6HOLE RT

Facility

$3,834.00

Hospital Charge Code	270676463
Hospital Revenue Code	278
Min. Negotiated Rate	$575.10
Max. Negotiated Rate	$927.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$843.48
Rate for Payer: Qualcare PPO/HMO/WC	$575.10

PLATE VA-LCP 2.7MM 6H RT STER

Facility

$4,280.75

Service Code	HCPCS C1713
Hospital Charge Code	270668008
Hospital Revenue Code	278
Min. Negotiated Rate	$642.11
Max. Negotiated Rate	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$941.76
Rate for Payer: Qualcare PPO/HMO/WC	$642.11

PLATE VA-LCP 2.7MM 6H RT STER

Facility

$4,280.75

Service Code	HCPCS C1713
Hospital Charge Code	270668008
Hospital Revenue Code	278
Min. Negotiated Rate	$103.17
Max. Negotiated Rate	$2,140.38
Rate for Payer: Aetna Commercial	$1,626.68
Rate for Payer: Aetna Medicare Advantage	$1,284.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,091.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,091.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,091.59
Rate for Payer: Cigna Commercial	$2,140.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$941.76
Rate for Payer: Qualcare PPO/HMO/WC	$642.11
Rate for Payer: UnitedHealthcare Community & State	$103.17
Rate for Payer: Wellpoint Medicaid Managed Care	$113.44

PLATE VA-LCP 2.7MM 7HOLE LEFT

Facility

$4,014.00

Hospital Charge Code	270676466
Hospital Revenue Code	278
Min. Negotiated Rate	$602.10
Max. Negotiated Rate	$971.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$883.08
Rate for Payer: Qualcare PPO/HMO/WC	$602.10

PLATE VA-LCP 2.7MM 7HOLE LEFT

Facility

$4,014.00

Hospital Charge Code	270676466
Hospital Revenue Code	278
Min. Negotiated Rate	$96.74
Max. Negotiated Rate	$2,007.00
Rate for Payer: Aetna Commercial	$1,525.32
Rate for Payer: Aetna Medicare Advantage	$1,204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.57
Rate for Payer: Cigna Commercial	$2,007.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$883.08
Rate for Payer: Qualcare PPO/HMO/WC	$602.10
Rate for Payer: UnitedHealthcare Community & State	$96.74
Rate for Payer: Wellpoint Medicaid Managed Care	$106.37

PLATE VA-LCP 2.7x73MM 2H RT ST

Facility

$4,125.15

Service Code	HCPCS C1713
Hospital Charge Code	270675394
Hospital Revenue Code	278
Min. Negotiated Rate	$618.77
Max. Negotiated Rate	$998.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.53
Rate for Payer: Qualcare PPO/HMO/WC	$618.77

PLATE VA-LCP 2.7x73MM 2H RT ST

Facility

$4,125.15

Service Code	HCPCS C1713
Hospital Charge Code	270675394
Hospital Revenue Code	278
Min. Negotiated Rate	$99.42
Max. Negotiated Rate	$2,062.57
Rate for Payer: Aetna Commercial	$1,567.56
Rate for Payer: Aetna Medicare Advantage	$1,237.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.91
Rate for Payer: Cigna Commercial	$2,062.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.53
Rate for Payer: Qualcare PPO/HMO/WC	$618.77
Rate for Payer: UnitedHealthcare Community & State	$99.42
Rate for Payer: Wellpoint Medicaid Managed Care	$109.32

PLATE VA-LCP 4HOLE LEFT 3.5

Facility

$6,912.85

Service Code	HCPCS C1713
Hospital Charge Code	270664331
Hospital Revenue Code	278
Min. Negotiated Rate	$166.60
Max. Negotiated Rate	$3,456.43
Rate for Payer: Aetna Commercial	$2,626.88
Rate for Payer: Aetna Medicare Advantage	$2,073.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,762.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,762.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,382.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,762.78
Rate for Payer: Cigna Commercial	$3,456.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,672.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,520.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,036.93
Rate for Payer: UnitedHealthcare Community & State	$166.60
Rate for Payer: Wellpoint Medicaid Managed Care	$183.19

PLATE VA-LCP 4HOLE LEFT 3.5

Facility

$6,912.85

Service Code	HCPCS C1713
Hospital Charge Code	270664331
Hospital Revenue Code	278
Min. Negotiated Rate	$1,036.93
Max. Negotiated Rate	$1,672.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,382.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,672.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,520.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,036.93

PLATE VA LCP CALCANEAL LEFT 2.

Facility

$4,656.25

Service Code	HCPCS C1713
Hospital Charge Code	270680485
Hospital Revenue Code	278
Min. Negotiated Rate	$698.44
Max. Negotiated Rate	$1,126.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$931.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,126.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,024.38
Rate for Payer: Qualcare PPO/HMO/WC	$698.44

Know your out-of-pocket cost for care.

All Charges