Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE ZIM SELF CMP NR 140MM 8H

Facility

$466.45

Hospital Charge Code	270605556
Hospital Revenue Code	278
Min. Negotiated Rate	$69.97
Max. Negotiated Rate	$112.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.62
Rate for Payer: Qualcare PPO/HMO/WC	$69.97

PLATE ZIM SELF COMP BRD 8-10HL

Facility

$403.00

Hospital Charge Code	1602564
Hospital Revenue Code	274
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$97.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.66
Rate for Payer: Qualcare PPO/HMO/WC	$60.45

PLATE ZIM SELF COMP BRD 8-10HL

Facility

$403.00

Hospital Charge Code	1602564
Hospital Revenue Code	274
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$201.50
Rate for Payer: Aetna Commercial	$153.14
Rate for Payer: Aetna Medicare Advantage	$120.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.77
Rate for Payer: Cigna Commercial	$201.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.66
Rate for Payer: Qualcare PPO/HMO/WC	$60.45
Rate for Payer: UnitedHealthcare Community & State	$9.71
Rate for Payer: Wellpoint Medicaid Managed Care	$10.68

PLATE ZIM TIB 40 5790-45-12

Facility

$4,131.25

Hospital Charge Code	270626740
Hospital Revenue Code	278
Min. Negotiated Rate	$619.69
Max. Negotiated Rate	$999.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$826.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$999.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$908.88
Rate for Payer: Qualcare PPO/HMO/WC	$619.69

PLATE ZIM TIB 40 5790-45-12

Facility

$4,131.25

Hospital Charge Code	270626740
Hospital Revenue Code	278
Min. Negotiated Rate	$99.56
Max. Negotiated Rate	$2,065.62
Rate for Payer: Aetna Commercial	$1,569.88
Rate for Payer: Aetna Medicare Advantage	$1,239.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,053.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,053.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$826.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,053.47
Rate for Payer: Cigna Commercial	$2,065.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$999.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$908.88
Rate for Payer: Qualcare PPO/HMO/WC	$619.69
Rate for Payer: UnitedHealthcare Community & State	$99.56
Rate for Payer: Wellpoint Medicaid Managed Care	$109.48

PLATE ZIM TIB 8H L 2347-008-8

Facility

$4,137.65

Hospital Charge Code	270620801
Hospital Revenue Code	278
Min. Negotiated Rate	$620.65
Max. Negotiated Rate	$1,001.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$827.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,001.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$910.28
Rate for Payer: Qualcare PPO/HMO/WC	$620.65

PLATE ZIM TIB 8H L 2347-008-8

Facility

$4,137.65

Hospital Charge Code	270620801
Hospital Revenue Code	278
Min. Negotiated Rate	$99.72
Max. Negotiated Rate	$2,068.82
Rate for Payer: Aetna Commercial	$1,572.31
Rate for Payer: Aetna Medicare Advantage	$1,241.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,055.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,055.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$827.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,055.10
Rate for Payer: Cigna Commercial	$2,068.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,001.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$910.28
Rate for Payer: Qualcare PPO/HMO/WC	$620.65
Rate for Payer: UnitedHealthcare Community & State	$99.72
Rate for Payer: Wellpoint Medicaid Managed Care	$109.65

PLAT FL COMP 2H 135D 118113502

Facility

$1,403.70

Hospital Charge Code	270639016
Hospital Revenue Code	278
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$339.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.81
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

PLAT FL COMP 2H 135D 118113502

Facility

$1,403.70

Hospital Charge Code	270639016
Hospital Revenue Code	278
Min. Negotiated Rate	$33.83
Max. Negotiated Rate	$701.85
Rate for Payer: Aetna Commercial	$533.41
Rate for Payer: Aetna Medicare Advantage	$421.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.94
Rate for Payer: Cigna Commercial	$701.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.81
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Community & State	$33.83
Rate for Payer: Wellpoint Medicaid Managed Care	$37.20

PLATING FUSION SM 3DI SYSTEM

Facility

$7,050.00

Hospital Charge Code	270702877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,551.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

PLATING FUSION SM 3DI SYSTEM

Facility

$7,050.00

Hospital Charge Code	270702877
Hospital Revenue Code	278
Min. Negotiated Rate	$169.91
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,679.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,551.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50
Rate for Payer: UnitedHealthcare Community & State	$169.91
Rate for Payer: Wellpoint Medicaid Managed Care	$186.82

PLATING ORTHOLOC 3DI MED RT

Facility

$7,445.00

Service Code	HCPCS C1713
Hospital Charge Code	270700804
Hospital Revenue Code	278
Min. Negotiated Rate	$179.42
Max. Negotiated Rate	$3,722.50
Rate for Payer: Aetna Commercial	$2,829.10
Rate for Payer: Aetna Medicare Advantage	$2,233.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,898.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,898.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,489.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,898.47
Rate for Payer: Cigna Commercial	$3,722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,801.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,637.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.75
Rate for Payer: UnitedHealthcare Community & State	$179.42
Rate for Payer: Wellpoint Medicaid Managed Care	$197.29

PLATING ORTHOLOC 3DI MED RT

Facility

$7,445.00

Service Code	HCPCS C1713
Hospital Charge Code	270700804
Hospital Revenue Code	278
Min. Negotiated Rate	$1,116.75
Max. Negotiated Rate	$1,801.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,489.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,801.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,637.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.75

PLATING WEDGE OPEN 4MM RIGHT

Facility

$7,351.50

Service Code	HCPCS C1713
Hospital Charge Code	270680167
Hospital Revenue Code	278
Min. Negotiated Rate	$1,102.72
Max. Negotiated Rate	$1,779.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,470.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,779.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,617.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,102.72

PLATING WEDGE OPEN 4MM RIGHT

Facility

$7,351.50

Service Code	HCPCS C1713
Hospital Charge Code	270680167
Hospital Revenue Code	278
Min. Negotiated Rate	$177.17
Max. Negotiated Rate	$3,675.75
Rate for Payer: Aetna Commercial	$2,793.57
Rate for Payer: Aetna Medicare Advantage	$2,205.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,874.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,874.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,470.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,874.63
Rate for Payer: Cigna Commercial	$3,675.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,779.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,617.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,102.72
Rate for Payer: UnitedHealthcare Community & State	$177.17
Rate for Payer: Wellpoint Medicaid Managed Care	$194.81

PLATINOL 10 MG

Facility

$164.00

Hospital Charge Code	60635305
Hospital Revenue Code	250
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$82.00
Rate for Payer: Aetna Commercial	$62.32
Rate for Payer: Aetna Medicare Advantage	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.82
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.20
Rate for Payer: Oxford Commercial	$32.80
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$32.80
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

PLATINOL 10 MG

Facility

$164.00

Hospital Charge Code	60635305
Hospital Revenue Code	250
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

PLATINOL-AQ/1MG/1ML

Facility

$516.00

Hospital Charge Code	60633669
Hospital Revenue Code	250
Min. Negotiated Rate	$12.44
Max. Negotiated Rate	$258.00
Rate for Payer: Aetna Commercial	$196.08
Rate for Payer: Aetna Medicare Advantage	$154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.58
Rate for Payer: Cigna Commercial	$258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.80
Rate for Payer: Oxford Commercial	$103.20
Rate for Payer: Qualcare PPO/HMO/WC	$77.40
Rate for Payer: UnitedHealthcare Commercial	$103.20
Rate for Payer: UnitedHealthcare Community & State	$12.44
Rate for Payer: Wellpoint Medicaid Managed Care	$13.67

PLATINOL-AQ/1MG/1ML

Facility

$516.00

Hospital Charge Code	60633669
Hospital Revenue Code	250
Min. Negotiated Rate	$77.40
Max. Negotiated Rate	$77.40
Rate for Payer: Qualcare PPO/HMO/WC	$77.40

PLAT VALCP COL-FUSN 2.7x78MM L

Facility

$5,920.45

Service Code	HCPCS C1713
Hospital Charge Code	270680262
Hospital Revenue Code	278
Min. Negotiated Rate	$888.07
Max. Negotiated Rate	$1,432.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,302.50
Rate for Payer: Qualcare PPO/HMO/WC	$888.07

PLAT VALCP COL-FUSN 2.7x78MM L

Facility

$5,920.45

Service Code	HCPCS C1713
Hospital Charge Code	270680262
Hospital Revenue Code	278
Min. Negotiated Rate	$142.68
Max. Negotiated Rate	$2,960.22
Rate for Payer: Aetna Commercial	$2,249.77
Rate for Payer: Aetna Medicare Advantage	$1,776.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,509.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,509.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,509.71
Rate for Payer: Cigna Commercial	$2,960.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,302.50
Rate for Payer: Qualcare PPO/HMO/WC	$888.07
Rate for Payer: UnitedHealthcare Community & State	$142.68
Rate for Payer: Wellpoint Medicaid Managed Care	$156.89

PLAT VA LKG CALC SM2.7x58MM LT

Facility

$4,341.45

Service Code	HCPCS C1713
Hospital Charge Code	270680302
Hospital Revenue Code	278
Min. Negotiated Rate	$104.63
Max. Negotiated Rate	$2,170.72
Rate for Payer: Aetna Commercial	$1,649.75
Rate for Payer: Aetna Medicare Advantage	$1,302.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,107.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,107.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$868.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,107.07
Rate for Payer: Cigna Commercial	$2,170.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,050.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$955.12
Rate for Payer: Qualcare PPO/HMO/WC	$651.22
Rate for Payer: UnitedHealthcare Community & State	$104.63
Rate for Payer: Wellpoint Medicaid Managed Care	$115.05

PLAT VA LKG CALC SM2.7x58MM LT

Facility

$4,341.45

Service Code	HCPCS C1713
Hospital Charge Code	270680302
Hospital Revenue Code	278
Min. Negotiated Rate	$651.22
Max. Negotiated Rate	$1,050.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$868.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,050.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$955.12
Rate for Payer: Qualcare PPO/HMO/WC	$651.22

PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	7411101
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	7411101
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

Know your out-of-pocket cost for care.

All Charges