Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE WIDE LOCKED RT 28x56MM

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270673691
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 WITH BAR STRAIGHT 4 HOLE

Facility

$2,500.00

Hospital Charge Code	270669466
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

PLATE WITH BAR STRAIGHT 4 HOLE

Facility

$2,500.00

Hospital Charge Code	270669466
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PLATE WLZ 4H 40 45DEG 01-9672

Facility

$760.85

Hospital Charge Code	270612244
Hospital Revenue Code	278
Min. Negotiated Rate	$114.13
Max. Negotiated Rate	$184.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.39
Rate for Payer: Qualcare PPO/HMO/WC	$114.13

PLATE WLZ 4H 40 45DEG 01-9672

Facility

$760.85

Hospital Charge Code	270612244
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$380.43
Rate for Payer: Aetna Commercial	$289.12
Rate for Payer: Aetna Medicare Advantage	$228.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.02
Rate for Payer: Cigna Commercial	$380.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.39
Rate for Payer: Qualcare PPO/HMO/WC	$114.13
Rate for Payer: UnitedHealthcare Community & State	$18.34
Rate for Payer: Wellpoint Medicaid Managed Care	$20.16

PLATE WLZ 4H ST 2.7 01-9641

Facility

$765.65

Hospital Charge Code	270622228
Hospital Revenue Code	278
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$382.82
Rate for Payer: Aetna Commercial	$290.95
Rate for Payer: Aetna Medicare Advantage	$229.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.24
Rate for Payer: Cigna Commercial	$382.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.44
Rate for Payer: Qualcare PPO/HMO/WC	$114.85
Rate for Payer: UnitedHealthcare Community & State	$18.45
Rate for Payer: Wellpoint Medicaid Managed Care	$20.29

PLATE WLZ 4H ST 2.7 01-9641

Facility

$765.65

Hospital Charge Code	270622228
Hospital Revenue Code	278
Min. Negotiated Rate	$114.85
Max. Negotiated Rate	$185.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.44
Rate for Payer: Qualcare PPO/HMO/WC	$114.85

PLATE WLZ BONE 6H 2MM 019289

Facility

$85.65

Hospital Charge Code	270620854
Hospital Revenue Code	278
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$32.55
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

PLATE WLZ BONE 6H 2MM 019289

Facility

$85.65

Hospital Charge Code	270620854
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

PLATE WLZ CURVED 6H 2MM 019224

Facility

$805.65

Hospital Charge Code	270620857
Hospital Revenue Code	278
Min. Negotiated Rate	$19.42
Max. Negotiated Rate	$402.82
Rate for Payer: Aetna Commercial	$306.15
Rate for Payer: Aetna Medicare Advantage	$241.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.44
Rate for Payer: Cigna Commercial	$402.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.24
Rate for Payer: Qualcare PPO/HMO/WC	$120.85
Rate for Payer: UnitedHealthcare Community & State	$19.42
Rate for Payer: Wellpoint Medicaid Managed Care	$21.35

PLATE WLZ CURVED 6H 2MM 019224

Facility

$805.65

Hospital Charge Code	270620857
Hospital Revenue Code	278
Min. Negotiated Rate	$120.85
Max. Negotiated Rate	$194.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.24
Rate for Payer: Qualcare PPO/HMO/WC	$120.85

PLATE WLZ L RT 2X2 HL 01-8015

Facility

$690.45

Hospital Charge Code	270607815
Hospital Revenue Code	278
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$262.37
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.57
Rate for Payer: UnitedHealthcare Community & State	$16.64
Rate for Payer: Wellpoint Medicaid Managed Care	$18.30

PLATE WLZ L RT 2X2 HL 01-8015

Facility

$690.45

Hospital Charge Code	270607815
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

PLATE WLZ L RT 2X2 HL 01-8052

Facility

$690.45

Hospital Charge Code	270607814
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

PLATE WLZ L RT 2X2 HL 01-8052

Facility

$690.45

Hospital Charge Code	270607814
Hospital Revenue Code	278
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$262.37
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.57
Rate for Payer: UnitedHealthcare Community & State	$16.64
Rate for Payer: Wellpoint Medicaid Managed Care	$18.30

PLATE WLZ MICRSYS 4H 01-9640

Facility

$959.25

Hospital Charge Code	270610839
Hospital Revenue Code	278
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

PLATE WLZ MICRSYS 4H 01-9640

Facility

$959.25

Hospital Charge Code	270610839
Hospital Revenue Code	278
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

PLATE WLZ ORB 4H 01-8010

Facility

$299.25

Hospital Charge Code	270622192
Hospital Revenue Code	278
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$149.62
Rate for Payer: Aetna Commercial	$113.72
Rate for Payer: Aetna Medicare Advantage	$89.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.31
Rate for Payer: Cigna Commercial	$149.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.83
Rate for Payer: Qualcare PPO/HMO/WC	$44.89
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

PLATE WLZ ORB 4H 01-8010

Facility

$299.25

Hospital Charge Code	270622192
Hospital Revenue Code	278
Min. Negotiated Rate	$44.89
Max. Negotiated Rate	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.83
Rate for Payer: Qualcare PPO/HMO/WC	$44.89

PLATE WLZ ORB 8H 01-8019

Facility

$551.25

Hospital Charge Code	270621847
Hospital Revenue Code	278
Min. Negotiated Rate	$13.29
Max. Negotiated Rate	$275.62
Rate for Payer: Aetna Commercial	$209.47
Rate for Payer: Aetna Medicare Advantage	$165.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.57
Rate for Payer: Cigna Commercial	$275.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.28
Rate for Payer: Qualcare PPO/HMO/WC	$82.69
Rate for Payer: UnitedHealthcare Community & State	$13.29
Rate for Payer: Wellpoint Medicaid Managed Care	$14.61

PLATE WLZ ORB 8H 01-8019

Facility

$551.25

Hospital Charge Code	270621847
Hospital Revenue Code	278
Min. Negotiated Rate	$82.69
Max. Negotiated Rate	$133.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.28
Rate for Payer: Qualcare PPO/HMO/WC	$82.69

PLATE WLZ ORB MED 5MM 915-2808

Facility

$2,440.00

Hospital Charge Code	270621790
Hospital Revenue Code	278
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$1,220.00
Rate for Payer: Aetna Commercial	$927.20
Rate for Payer: Aetna Medicare Advantage	$732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.20
Rate for Payer: Cigna Commercial	$1,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$536.80
Rate for Payer: Qualcare PPO/HMO/WC	$366.00
Rate for Payer: UnitedHealthcare Community & State	$58.80
Rate for Payer: Wellpoint Medicaid Managed Care	$64.66

PLATE WLZ ORB MED 5MM 915-2808

Facility

$2,440.00

Hospital Charge Code	270621790
Hospital Revenue Code	278
Min. Negotiated Rate	$366.00
Max. Negotiated Rate	$590.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$536.80
Rate for Payer: Qualcare PPO/HMO/WC	$366.00

PLATE X LORDTIR

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688431
Hospital Revenue Code	278
Min. Negotiated Rate	$1,987.50
Max. Negotiated Rate	$3,206.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,915.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50

PLATE X LORDTIR

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688431
Hospital Revenue Code	278
Min. Negotiated Rate	$319.32
Max. Negotiated Rate	$6,625.00
Rate for Payer: Aetna Commercial	$5,035.00
Rate for Payer: Aetna Medicare Advantage	$3,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.75
Rate for Payer: Cigna Commercial	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,915.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50
Rate for Payer: UnitedHealthcare Community & State	$319.32
Rate for Payer: Wellpoint Medicaid Managed Care	$351.12

Know your out-of-pocket cost for care.

All Charges