Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VHS 6HOLE KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	270635311
Hospital Revenue Code	278
Min. Negotiated Rate	$43.63
Max. Negotiated Rate	$905.23
Rate for Payer: Aetna Commercial	$687.97
Rate for Payer: Aetna Medicare Advantage	$543.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.66
Rate for Payer: Cigna Commercial	$905.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.30
Rate for Payer: Qualcare PPO/HMO/WC	$271.57
Rate for Payer: UnitedHealthcare Community & State	$43.63
Rate for Payer: Wellpoint Medicaid Managed Care	$47.98

PLATE VHS 6HOLE KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	270635311
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$438.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.30
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

PLATE VHS 6-HOL KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	70635311
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$438.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.30
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

PLATE VHS 6-HOL KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	70635311
Hospital Revenue Code	278
Min. Negotiated Rate	$43.63
Max. Negotiated Rate	$905.23
Rate for Payer: Aetna Commercial	$687.97
Rate for Payer: Aetna Medicare Advantage	$543.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.66
Rate for Payer: Cigna Commercial	$905.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$398.30
Rate for Payer: Qualcare PPO/HMO/WC	$271.57
Rate for Payer: UnitedHealthcare Community & State	$43.63
Rate for Payer: Wellpoint Medicaid Managed Care	$47.98

PLATE VOLAR 3H SHORT RT DVRASR

Facility

$3,447.25

Hospital Charge Code	270636495
Hospital Revenue Code	278
Min. Negotiated Rate	$83.08
Max. Negotiated Rate	$1,723.62
Rate for Payer: Aetna Commercial	$1,309.95
Rate for Payer: Aetna Medicare Advantage	$1,034.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.05
Rate for Payer: Cigna Commercial	$1,723.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$758.39
Rate for Payer: Qualcare PPO/HMO/WC	$517.09
Rate for Payer: UnitedHealthcare Community & State	$83.08
Rate for Payer: Wellpoint Medicaid Managed Care	$91.35

PLATE VOLAR 3H SHORT RT DVRASR

Facility

$3,447.25

Hospital Charge Code	270636495
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$834.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$758.39
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

PLATE VOLAR DBL TIER RT DVR AR

Facility

$3,447.25

Hospital Charge Code	270635656
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$834.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$758.39
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

PLATE VOLAR DBL TIER RT DVR AR

Facility

$3,447.25

Hospital Charge Code	270635656
Hospital Revenue Code	278
Min. Negotiated Rate	$83.08
Max. Negotiated Rate	$1,723.62
Rate for Payer: Aetna Commercial	$1,309.95
Rate for Payer: Aetna Medicare Advantage	$1,034.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.05
Rate for Payer: Cigna Commercial	$1,723.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$758.39
Rate for Payer: Qualcare PPO/HMO/WC	$517.09
Rate for Payer: UnitedHealthcare Community & State	$83.08
Rate for Payer: Wellpoint Medicaid Managed Care	$91.35

PLATE VOLAR DIST RADIUS 3H/LF

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678459
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE VOLAR DIST RADIUS 3H/LF

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678459
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

PLATE VOLAR DR L54 4 HOLE

Facility

$9,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705669
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 VOLAR DR L54 4 HOLE

Facility

$9,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705669
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 VOLAR RADIUS 3H L STD

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270661791
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

PLATE VOLAR RADIUS 3H L STD

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270661791
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE WAISTED COMPR 10H 136MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270671803
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

PLATE WAISTED COMPR 10H 136MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270671803
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$499.70
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25
Rate for Payer: UnitedHealthcare Community & State	$31.69
Rate for Payer: Wellpoint Medicaid Managed Care	$34.85

PLATE WAISTED COMPR 8H 4x110MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270664730
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$499.70
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25
Rate for Payer: UnitedHealthcare Community & State	$31.69
Rate for Payer: Wellpoint Medicaid Managed Care	$34.85

PLATE WAISTED COMPR 8H 4x110MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270664730
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

PLATE WAISTED NRW 2H 187MM

Facility

$1,485.00

Hospital Charge Code	270673797
Hospital Revenue Code	278
Min. Negotiated Rate	$35.79
Max. Negotiated Rate	$742.50
Rate for Payer: Aetna Commercial	$564.30
Rate for Payer: Aetna Medicare Advantage	$445.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.68
Rate for Payer: Cigna Commercial	$742.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$326.70
Rate for Payer: Qualcare PPO/HMO/WC	$222.75
Rate for Payer: UnitedHealthcare Community & State	$35.79
Rate for Payer: Wellpoint Medicaid Managed Care	$39.35

PLATE WAISTED NRW 2H 187MM

Facility

$1,485.00

Hospital Charge Code	270673797
Hospital Revenue Code	278
Min. Negotiated Rate	$222.75
Max. Negotiated Rate	$359.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$326.70
Rate for Payer: Qualcare PPO/HMO/WC	$222.75

PLATE WEDGE BASE OPEN 4MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677039
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE WEDGE BASE OPEN 4MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677039
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

PLATE WIDE LOCKED 28x56mm

Facility

$5,720.00

Service Code	HCPCS C1713
Hospital Charge Code	270672339
Hospital Revenue Code	278
Min. Negotiated Rate	$858.00
Max. Negotiated Rate	$1,384.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$858.00

PLATE WIDE LOCKED 28x56mm

Facility

$5,720.00

Service Code	HCPCS C1713
Hospital Charge Code	270672339
Hospital Revenue Code	278
Min. Negotiated Rate	$137.85
Max. Negotiated Rate	$2,860.00
Rate for Payer: Aetna Commercial	$2,173.60
Rate for Payer: Aetna Medicare Advantage	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,458.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,458.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,458.60
Rate for Payer: Cigna Commercial	$2,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$858.00
Rate for Payer: UnitedHealthcare Community & State	$137.85
Rate for Payer: Wellpoint Medicaid Managed Care	$151.58

PLATE WIDE LOCKED RT 28x56MM

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270673691
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

Know your out-of-pocket cost for care.

All Charges