Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$94.21
Max. Negotiated Rate	$1,954.50
Rate for Payer: Aetna Commercial	$1,485.42
Rate for Payer: Aetna Medicare Advantage	$1,172.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$996.79
Rate for Payer: Cigna Commercial	$1,954.50
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
Rate for Payer: UnitedHealthcare Community & State	$94.21
Rate for Payer: Wellpoint Medicaid Managed Care	$103.59

PLATE VA-LCP VOL 2.4MM 6H/5H R

Facility

$4,567.00

Service Code	HCPCS C1713
Hospital Charge Code	270676432
Hospital Revenue Code	278
Min. Negotiated Rate	$110.06
Max. Negotiated Rate	$2,283.50
Rate for Payer: Aetna Commercial	$1,735.46
Rate for Payer: Aetna Medicare Advantage	$1,370.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,164.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,164.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$913.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,164.59
Rate for Payer: Cigna Commercial	$2,283.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,004.74
Rate for Payer: Qualcare PPO/HMO/WC	$685.05
Rate for Payer: UnitedHealthcare Community & State	$110.06
Rate for Payer: Wellpoint Medicaid Managed Care	$121.03

PLATE VA-LCP VOL 2.4MM 6H/5H R

Facility

$5,119.40

Service Code	HCPCS C1713
Hospital Charge Code	270688223
Hospital Revenue Code	278
Min. Negotiated Rate	$767.91
Max. Negotiated Rate	$1,238.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,238.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,126.27
Rate for Payer: Qualcare PPO/HMO/WC	$767.91

PLATE VA-LCP VOL 2.4MM 6H/5H R

Facility

$4,567.00

Service Code	HCPCS C1713
Hospital Charge Code	270676432
Hospital Revenue Code	278
Min. Negotiated Rate	$685.05
Max. Negotiated Rate	$1,105.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$913.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,004.74
Rate for Payer: Qualcare PPO/HMO/WC	$685.05

PLATE VA-LCP VOL 2.4MM 6H/5H R

Facility

$5,119.40

Service Code	HCPCS C1713
Hospital Charge Code	270688223
Hospital Revenue Code	278
Min. Negotiated Rate	$123.38
Max. Negotiated Rate	$2,559.70
Rate for Payer: Aetna Commercial	$1,945.37
Rate for Payer: Aetna Medicare Advantage	$1,535.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,305.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,305.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,305.45
Rate for Payer: Cigna Commercial	$2,559.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,238.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,126.27
Rate for Payer: Qualcare PPO/HMO/WC	$767.91
Rate for Payer: UnitedHealthcare Community & State	$123.38
Rate for Payer: Wellpoint Medicaid Managed Care	$135.66

PLATE VA-LCP VOLR 2.4 6H/5H LT

Facility

$4,408.05

Service Code	HCPCS C1713
Hospital Charge Code	270675139
Hospital Revenue Code	278
Min. Negotiated Rate	$661.21
Max. Negotiated Rate	$1,066.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$969.77
Rate for Payer: Qualcare PPO/HMO/WC	$661.21

PLATE VA-LCP VOLR 2.4 6H/5H LT

Facility

$4,408.05

Service Code	HCPCS C1713
Hospital Charge Code	270675139
Hospital Revenue Code	278
Min. Negotiated Rate	$106.23
Max. Negotiated Rate	$2,204.03
Rate for Payer: Aetna Commercial	$1,675.06
Rate for Payer: Aetna Medicare Advantage	$1,322.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.05
Rate for Payer: Cigna Commercial	$2,204.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$969.77
Rate for Payer: Qualcare PPO/HMO/WC	$661.21
Rate for Payer: UnitedHealthcare Community & State	$106.23
Rate for Payer: Wellpoint Medicaid Managed Care	$116.81

PLATE VA LKG CLC 2.7x70MM LTST

Facility

$4,712.25

Hospital Charge Code	270678308
Hospital Revenue Code	278
Min. Negotiated Rate	$706.84
Max. Negotiated Rate	$1,140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,036.69
Rate for Payer: Qualcare PPO/HMO/WC	$706.84

PLATE VA LKG CLC 2.7x70MM LTST

Facility

$4,712.25

Hospital Charge Code	270678308
Hospital Revenue Code	278
Min. Negotiated Rate	$113.57
Max. Negotiated Rate	$2,356.12
Rate for Payer: Aetna Commercial	$1,790.65
Rate for Payer: Aetna Medicare Advantage	$1,413.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,201.62
Rate for Payer: Cigna Commercial	$2,356.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,036.69
Rate for Payer: Qualcare PPO/HMO/WC	$706.84
Rate for Payer: UnitedHealthcare Community & State	$113.57
Rate for Payer: Wellpoint Medicaid Managed Care	$124.87

PLATE VARIAX COMPR STR 8H102MM

Facility

$4,555.35

Service Code	HCPCS C1713
Hospital Charge Code	270692172
Hospital Revenue Code	278
Min. Negotiated Rate	$683.30
Max. Negotiated Rate	$1,102.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$911.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,002.18
Rate for Payer: Qualcare PPO/HMO/WC	$683.30

PLATE VARIAX COMPR STR 8H102MM

Facility

$4,555.35

Service Code	HCPCS C1713
Hospital Charge Code	270692172
Hospital Revenue Code	278
Min. Negotiated Rate	$109.78
Max. Negotiated Rate	$2,277.68
Rate for Payer: Aetna Commercial	$1,731.03
Rate for Payer: Aetna Medicare Advantage	$1,366.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$911.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,161.61
Rate for Payer: Cigna Commercial	$2,277.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,002.18
Rate for Payer: Qualcare PPO/HMO/WC	$683.30
Rate for Payer: UnitedHealthcare Community & State	$109.78
Rate for Payer: Wellpoint Medicaid Managed Care	$120.72

PLATE VARIAX FIBULA 5 HOLES

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270667255
Hospital Revenue Code	278
Min. Negotiated Rate	$686.25
Max. Negotiated Rate	$1,107.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,107.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,006.50
Rate for Payer: Qualcare PPO/HMO/WC	$686.25

PLATE VARIAX FIBULA 5 HOLES

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270667255
Hospital Revenue Code	278
Min. Negotiated Rate	$110.26
Max. Negotiated Rate	$2,287.50
Rate for Payer: Aetna Commercial	$1,738.50
Rate for Payer: Aetna Medicare Advantage	$1,372.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,166.62
Rate for Payer: Cigna Commercial	$2,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,107.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,006.50
Rate for Payer: Qualcare PPO/HMO/WC	$686.25
Rate for Payer: UnitedHealthcare Community & State	$110.26
Rate for Payer: Wellpoint Medicaid Managed Care	$121.24

PLATE VDF 6 HOLE

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664947
Hospital Revenue Code	278
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$1,148.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,043.90
Rate for Payer: Qualcare PPO/HMO/WC	$711.75

PLATE VDF 6 HOLE

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664947
Hospital Revenue Code	278
Min. Negotiated Rate	$114.35
Max. Negotiated Rate	$2,372.50
Rate for Payer: Aetna Commercial	$1,803.10
Rate for Payer: Aetna Medicare Advantage	$1,423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,209.97
Rate for Payer: Cigna Commercial	$2,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,043.90
Rate for Payer: Qualcare PPO/HMO/WC	$711.75
Rate for Payer: UnitedHealthcare Community & State	$114.35
Rate for Payer: Wellpoint Medicaid Managed Care	$125.74

PLATE VDF 9 HOLES 149mm

Facility

$5,155.00

Hospital Charge Code	270665756
Hospital Revenue Code	278
Min. Negotiated Rate	$773.25
Max. Negotiated Rate	$1,247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,031.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,247.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,134.10
Rate for Payer: Qualcare PPO/HMO/WC	$773.25

PLATE VDF 9 HOLES 149mm

Facility

$5,155.00

Hospital Charge Code	270665756
Hospital Revenue Code	278
Min. Negotiated Rate	$124.24
Max. Negotiated Rate	$2,577.50
Rate for Payer: Aetna Commercial	$1,958.90
Rate for Payer: Aetna Medicare Advantage	$1,546.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,314.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,314.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,031.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,314.53
Rate for Payer: Cigna Commercial	$2,577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,247.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,134.10
Rate for Payer: Qualcare PPO/HMO/WC	$773.25
Rate for Payer: UnitedHealthcare Community & State	$124.24
Rate for Payer: Wellpoint Medicaid Managed Care	$136.61

PLATE VDR 4HOLE

Facility

$9,075.00

Hospital Charge Code	270703377
Hospital Revenue Code	278
Min. Negotiated Rate	$218.71
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$3,448.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
Rate for Payer: UnitedHealthcare Community & State	$218.71
Rate for Payer: Wellpoint Medicaid Managed Care	$240.49

PLATE VDR 4HOLE

Facility

$9,075.00

Hospital Charge Code	270703377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

PLATE VDR RT NARROW

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270647991
Hospital Revenue Code	278
Min. Negotiated Rate	$136.65
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$2,154.60
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50
Rate for Payer: UnitedHealthcare Community & State	$136.65
Rate for Payer: Wellpoint Medicaid Managed Care	$150.25

PLATE VDR RT NARROW

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270647991
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$1,372.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

PLATE VERSA FX 4H 86MM 135 ANG

Facility

$2,126.25

Hospital Charge Code	270673058
Hospital Revenue Code	278
Min. Negotiated Rate	$51.24
Max. Negotiated Rate	$1,063.12
Rate for Payer: Aetna Commercial	$807.98
Rate for Payer: Aetna Medicare Advantage	$637.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$542.19
Rate for Payer: Cigna Commercial	$1,063.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.77
Rate for Payer: Qualcare PPO/HMO/WC	$318.94
Rate for Payer: UnitedHealthcare Community & State	$51.24
Rate for Payer: Wellpoint Medicaid Managed Care	$56.35

PLATE VERSA FX 4H 86MM 135 ANG

Facility

$2,126.25

Hospital Charge Code	270673058
Hospital Revenue Code	278
Min. Negotiated Rate	$318.94
Max. Negotiated Rate	$514.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.77
Rate for Payer: Qualcare PPO/HMO/WC	$318.94

PLATE VHS 6 HOLE KEYLESS

Facility

$1,675.00

Hospital Charge Code	270658680
Hospital Revenue Code	278
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$405.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$368.50
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

PLATE VHS 6 HOLE KEYLESS

Facility

$1,675.00

Hospital Charge Code	270658680
Hospital Revenue Code	278
Min. Negotiated Rate	$40.37
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$636.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$368.50
Rate for Payer: Qualcare PPO/HMO/WC	$251.25
Rate for Payer: UnitedHealthcare Community & State	$40.37
Rate for Payer: Wellpoint Medicaid Managed Care	$44.39

Know your out-of-pocket cost for care.

All Charges