Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VA-LCP LAT 2.7MM 7H R

Facility

$4,134.40

Service Code	HCPCS C1713
Hospital Charge Code	270676465
Hospital Revenue Code	278
Min. Negotiated Rate	$99.64
Max. Negotiated Rate	$2,067.20
Rate for Payer: Aetna Commercial	$1,571.07
Rate for Payer: Aetna Medicare Advantage	$1,240.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,054.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,054.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$826.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,054.27
Rate for Payer: Cigna Commercial	$2,067.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,000.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$909.57
Rate for Payer: Qualcare PPO/HMO/WC	$620.16
Rate for Payer: UnitedHealthcare Community & State	$99.64
Rate for Payer: Wellpoint Medicaid Managed Care	$109.56

PLATE VA-LCP LAT 2.7MM 7H R

Facility

$4,134.40

Service Code	HCPCS C1713
Hospital Charge Code	270676465
Hospital Revenue Code	278
Min. Negotiated Rate	$620.16
Max. Negotiated Rate	$1,000.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$826.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,000.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$909.57
Rate for Payer: Qualcare PPO/HMO/WC	$620.16

PLATE VA LCP LAT 2.7MM 7H RT S

Facility

$4,471.70

Service Code	HCPCS C1713
Hospital Charge Code	270680328
Hospital Revenue Code	278
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$2,235.85
Rate for Payer: Aetna Commercial	$1,699.25
Rate for Payer: Aetna Medicare Advantage	$1,341.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,140.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,140.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$894.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,140.28
Rate for Payer: Cigna Commercial	$2,235.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$983.77
Rate for Payer: Qualcare PPO/HMO/WC	$670.75
Rate for Payer: UnitedHealthcare Community & State	$107.77
Rate for Payer: Wellpoint Medicaid Managed Care	$118.50

PLATE VA LCP LAT 2.7MM 7H RT S

Facility

$4,471.70

Service Code	HCPCS C1713
Hospital Charge Code	270680328
Hospital Revenue Code	278
Min. Negotiated Rate	$670.75
Max. Negotiated Rate	$1,082.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$894.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$983.77
Rate for Payer: Qualcare PPO/HMO/WC	$670.75

PLATE VA-LCP LG BND 4H 87MM RT

Facility

$6,516.00

Service Code	HCPCS C1713
Hospital Charge Code	270675180
Hospital Revenue Code	278
Min. Negotiated Rate	$157.04
Max. Negotiated Rate	$3,258.00
Rate for Payer: Aetna Commercial	$2,476.08
Rate for Payer: Aetna Medicare Advantage	$1,954.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,661.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,661.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,303.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,661.58
Rate for Payer: Cigna Commercial	$3,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,576.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,433.52
Rate for Payer: Qualcare PPO/HMO/WC	$977.40
Rate for Payer: UnitedHealthcare Community & State	$157.04
Rate for Payer: Wellpoint Medicaid Managed Care	$172.67

PLATE VA-LCP LG BND 4H 87MM RT

Facility

$6,516.00

Service Code	HCPCS C1713
Hospital Charge Code	270675180
Hospital Revenue Code	278
Min. Negotiated Rate	$977.40
Max. Negotiated Rate	$1,576.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,303.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,576.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,433.52
Rate for Payer: Qualcare PPO/HMO/WC	$977.40

PLATE VA-LCP LG BND 6H 117MM L

Facility

$6,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270676493
Hospital Revenue Code	278
Min. Negotiated Rate	$987.75
Max. Negotiated Rate	$1,593.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,448.70
Rate for Payer: Qualcare PPO/HMO/WC	$987.75

PLATE VA-LCP LG BND 6H 117MM L

Facility

$6,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270676493
Hospital Revenue Code	278
Min. Negotiated Rate	$158.70
Max. Negotiated Rate	$3,292.50
Rate for Payer: Aetna Commercial	$2,502.30
Rate for Payer: Aetna Medicare Advantage	$1,975.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,679.17
Rate for Payer: Cigna Commercial	$3,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,448.70
Rate for Payer: Qualcare PPO/HMO/WC	$987.75
Rate for Payer: UnitedHealthcare Community & State	$158.70
Rate for Payer: Wellpoint Medicaid Managed Care	$174.50

PLATE VA-LCP MEDIAL 3.5x95MM L

Facility

$6,425.85

Service Code	HCPCS C1713
Hospital Charge Code	270681459
Hospital Revenue Code	278
Min. Negotiated Rate	$963.88
Max. Negotiated Rate	$1,555.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,555.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.69
Rate for Payer: Qualcare PPO/HMO/WC	$963.88

PLATE VA-LCP MEDIAL 3.5x95MM L

Facility

$6,425.85

Service Code	HCPCS C1713
Hospital Charge Code	270681459
Hospital Revenue Code	278
Min. Negotiated Rate	$154.86
Max. Negotiated Rate	$3,212.93
Rate for Payer: Aetna Commercial	$2,441.82
Rate for Payer: Aetna Medicare Advantage	$1,927.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.59
Rate for Payer: Cigna Commercial	$3,212.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,555.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.69
Rate for Payer: Qualcare PPO/HMO/WC	$963.88
Rate for Payer: UnitedHealthcare Community & State	$154.86
Rate for Payer: Wellpoint Medicaid Managed Care	$170.29

PLATE VA-LCP RAD 2.4 2COL 6H/2

Facility

$4,081.90

Service Code	HCPCS C1713
Hospital Charge Code	270679923
Hospital Revenue Code	278
Min. Negotiated Rate	$98.37
Max. Negotiated Rate	$2,040.95
Rate for Payer: Aetna Commercial	$1,551.12
Rate for Payer: Aetna Medicare Advantage	$1,224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,040.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,040.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,040.88
Rate for Payer: Cigna Commercial	$2,040.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$898.02
Rate for Payer: Qualcare PPO/HMO/WC	$612.28
Rate for Payer: UnitedHealthcare Community & State	$98.37
Rate for Payer: Wellpoint Medicaid Managed Care	$108.17

PLATE VA-LCP RAD 2.4 2COL 6H/2

Facility

$4,081.90

Service Code	HCPCS C1713
Hospital Charge Code	270679923
Hospital Revenue Code	278
Min. Negotiated Rate	$612.28
Max. Negotiated Rate	$987.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$898.02
Rate for Payer: Qualcare PPO/HMO/WC	$612.28

PLATE VA-LCP RAD CLMN 5HOLE

Facility

$2,280.40

Service Code	HCPCS C1713
Hospital Charge Code	270666941
Hospital Revenue Code	278
Min. Negotiated Rate	$342.06
Max. Negotiated Rate	$551.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.69
Rate for Payer: Qualcare PPO/HMO/WC	$342.06

PLATE VA-LCP RAD CLMN 5HOLE

Facility

$2,280.40

Service Code	HCPCS C1713
Hospital Charge Code	270666941
Hospital Revenue Code	278
Min. Negotiated Rate	$54.96
Max. Negotiated Rate	$1,140.20
Rate for Payer: Aetna Commercial	$866.55
Rate for Payer: Aetna Medicare Advantage	$684.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.50
Rate for Payer: Cigna Commercial	$1,140.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.69
Rate for Payer: Qualcare PPO/HMO/WC	$342.06
Rate for Payer: UnitedHealthcare Community & State	$54.96
Rate for Payer: Wellpoint Medicaid Managed Care	$60.43

PLATE VA-LCP SM BND 4H 87MM LT

Facility

$6,699.60

Service Code	HCPCS C1713
Hospital Charge Code	270676135
Hospital Revenue Code	278
Min. Negotiated Rate	$1,004.94
Max. Negotiated Rate	$1,621.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,339.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,621.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,473.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,004.94

PLATE VA-LCP SM BND 4H 87MM LT

Facility

$6,699.60

Service Code	HCPCS C1713
Hospital Charge Code	270676135
Hospital Revenue Code	278
Min. Negotiated Rate	$161.46
Max. Negotiated Rate	$3,349.80
Rate for Payer: Aetna Commercial	$2,545.85
Rate for Payer: Aetna Medicare Advantage	$2,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,339.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.40
Rate for Payer: Cigna Commercial	$3,349.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,621.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,473.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,004.94
Rate for Payer: UnitedHealthcare Community & State	$161.46
Rate for Payer: Wellpoint Medicaid Managed Care	$177.54

PLATE VA-LCP SM BND 6H 117MM R

Facility

$6,384.00

Service Code	HCPCS C1713
Hospital Charge Code	270659781
Hospital Revenue Code	278
Min. Negotiated Rate	$957.60
Max. Negotiated Rate	$1,544.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,276.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,544.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,404.48
Rate for Payer: Qualcare PPO/HMO/WC	$957.60

PLATE VA-LCP SM BND 6H 117MM R

Facility

$6,986.05

Service Code	HCPCS C1713
Hospital Charge Code	270679097
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.91
Max. Negotiated Rate	$1,690.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,397.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,690.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.91

PLATE VA-LCP SM BND 6H 117MM R

Facility

$6,384.00

Service Code	HCPCS C1713
Hospital Charge Code	270659781
Hospital Revenue Code	278
Min. Negotiated Rate	$153.85
Max. Negotiated Rate	$3,192.00
Rate for Payer: Aetna Commercial	$2,425.92
Rate for Payer: Aetna Medicare Advantage	$1,915.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,627.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,627.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,276.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,627.92
Rate for Payer: Cigna Commercial	$3,192.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,544.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,404.48
Rate for Payer: Qualcare PPO/HMO/WC	$957.60
Rate for Payer: UnitedHealthcare Community & State	$153.85
Rate for Payer: Wellpoint Medicaid Managed Care	$169.18

PLATE VA-LCP SM BND 6H 117MM R

Facility

$6,986.05

Service Code	HCPCS C1713
Hospital Charge Code	270679097
Hospital Revenue Code	278
Min. Negotiated Rate	$168.36
Max. Negotiated Rate	$3,493.03
Rate for Payer: Aetna Commercial	$2,654.70
Rate for Payer: Aetna Medicare Advantage	$2,095.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,781.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,781.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,397.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,781.44
Rate for Payer: Cigna Commercial	$3,493.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,690.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.91
Rate for Payer: UnitedHealthcare Community & State	$168.36
Rate for Payer: Wellpoint Medicaid Managed Care	$185.13

PLATE VA-LCP SM BND 6H 117MM S

Facility

$6,986.05

Service Code	HCPCS C1713
Hospital Charge Code	270676516
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.91
Max. Negotiated Rate	$1,690.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,397.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,690.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.91

PLATE VA-LCP SM BND 6H 117MM S

Facility

$6,986.05

Service Code	HCPCS C1713
Hospital Charge Code	270676516
Hospital Revenue Code	278
Min. Negotiated Rate	$168.36
Max. Negotiated Rate	$3,493.03
Rate for Payer: Aetna Commercial	$2,654.70
Rate for Payer: Aetna Medicare Advantage	$2,095.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,781.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,781.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,397.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,781.44
Rate for Payer: Cigna Commercial	$3,493.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,690.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.91
Rate for Payer: UnitedHealthcare Community & State	$168.36
Rate for Payer: Wellpoint Medicaid Managed Care	$185.13

PLATE VA-LCP SM BND 8H 147MM

Facility

$7,918.55

Service Code	HCPCS C1713
Hospital Charge Code	270680907
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.78
Max. Negotiated Rate	$1,916.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,742.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.78

PLATE VA-LCP SM BND 8H 147MM

Facility

$7,918.55

Service Code	HCPCS C1713
Hospital Charge Code	270680907
Hospital Revenue Code	278
Min. Negotiated Rate	$190.84
Max. Negotiated Rate	$3,959.28
Rate for Payer: Aetna Commercial	$3,009.05
Rate for Payer: Aetna Medicare Advantage	$2,375.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,019.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,019.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,019.23
Rate for Payer: Cigna Commercial	$3,959.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,742.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.78
Rate for Payer: UnitedHealthcare Community & State	$190.84
Rate for Payer: Wellpoint Medicaid Managed Care	$209.84

PLATE VA-LCP TMT FUSN 2.4

Facility

$3,909.00

Service Code	HCPCS C1713
Hospital Charge Code	270687830
Hospital Revenue Code	278
Min. Negotiated Rate	$586.35
Max. Negotiated Rate	$945.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$859.98
Rate for Payer: Qualcare PPO/HMO/WC	$586.35

Know your out-of-pocket cost for care.

All Charges