Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLT VA-LCP AC 2.7X3.5MM 9H89MM

Facility

$5,051.60

Service Code	HCPCS C1713
Hospital Charge Code	270693550
Hospital Revenue Code	278
Min. Negotiated Rate	$757.74
Max. Negotiated Rate	$1,222.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,111.35
Rate for Payer: Qualcare PPO/HMO/WC	$757.74

PLUG 10MM FRES H

Facility

$12,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270685328
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

PLUG 10MM FRES H

Facility

$12,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270685328
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

PLUG ACETABULAR DOME HOLE

Facility

$336.00

Hospital Charge Code	270676580
Hospital Revenue Code	278
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$127.68
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.92
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Community & State	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.90

PLUG ACETABULAR DOME HOLE

Facility

$336.00

Hospital Charge Code	270676580
Hospital Revenue Code	278
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$81.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.92
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

PLUG ATK ACL BONE 909693

Facility

$139.25

Hospital Charge Code	270613295
Hospital Revenue Code	272
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$69.62
Rate for Payer: Aetna Commercial	$52.91
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.77
Rate for Payer: Oxford Commercial	$27.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$27.85
Rate for Payer: UnitedHealthcare Community & State	$3.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

PLUG ATK ACL BONE 909693

Facility

$139.25

Hospital Charge Code	270613295
Hospital Revenue Code	272
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

PLUG BIO-A

Facility

$1,265.00

Hospital Charge Code	270664707
Hospital Revenue Code	270
Min. Negotiated Rate	$30.49
Max. Negotiated Rate	$632.50
Rate for Payer: Aetna Commercial	$480.70
Rate for Payer: Aetna Medicare Advantage	$379.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.57
Rate for Payer: Cigna Commercial	$632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.50
Rate for Payer: Oxford Commercial	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$189.75
Rate for Payer: UnitedHealthcare Commercial	$253.00
Rate for Payer: UnitedHealthcare Community & State	$30.49
Rate for Payer: Wellpoint Medicaid Managed Care	$33.52

PLUG BIO-A

Facility

$1,265.00

Hospital Charge Code	270664707
Hospital Revenue Code	270
Min. Negotiated Rate	$189.75
Max. Negotiated Rate	$189.75
Rate for Payer: Qualcare PPO/HMO/WC	$189.75

PLUG BMT BONE IM 12MM 130609

Facility

$607.25

Hospital Charge Code	270620286
Hospital Revenue Code	278
Min. Negotiated Rate	$91.09
Max. Negotiated Rate	$146.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.59
Rate for Payer: Qualcare PPO/HMO/WC	$91.09

PLUG BMT BONE IM 12MM 130609

Facility

$607.25

Hospital Charge Code	270620286
Hospital Revenue Code	278
Min. Negotiated Rate	$14.63
Max. Negotiated Rate	$303.62
Rate for Payer: Aetna Commercial	$230.75
Rate for Payer: Aetna Medicare Advantage	$182.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.85
Rate for Payer: Cigna Commercial	$303.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.59
Rate for Payer: Qualcare PPO/HMO/WC	$91.09
Rate for Payer: UnitedHealthcare Community & State	$14.63
Rate for Payer: Wellpoint Medicaid Managed Care	$16.09

PLUG BMT BONE IM 16MM 130611

Facility

$598.45

Hospital Charge Code	270608157
Hospital Revenue Code	278
Min. Negotiated Rate	$14.42
Max. Negotiated Rate	$299.23
Rate for Payer: Aetna Commercial	$227.41
Rate for Payer: Aetna Medicare Advantage	$179.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.60
Rate for Payer: Cigna Commercial	$299.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.66
Rate for Payer: Qualcare PPO/HMO/WC	$89.77
Rate for Payer: UnitedHealthcare Community & State	$14.42
Rate for Payer: Wellpoint Medicaid Managed Care	$15.86

PLUG BMT BONE IM 16MM 130611

Facility

$598.45

Hospital Charge Code	270608157
Hospital Revenue Code	278
Min. Negotiated Rate	$89.77
Max. Negotiated Rate	$144.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.66
Rate for Payer: Qualcare PPO/HMO/WC	$89.77

PLUG CANN D=8 L=16MM

Facility

$2,409.75

Service Code	HCPCS C1889
Hospital Charge Code	270704122
Hospital Revenue Code	278
Min. Negotiated Rate	$58.07
Max. Negotiated Rate	$1,204.88
Rate for Payer: Aetna Commercial	$915.71
Rate for Payer: Aetna Medicare Advantage	$722.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$614.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$614.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$614.49
Rate for Payer: Cigna Commercial	$1,204.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$530.14
Rate for Payer: Qualcare PPO/HMO/WC	$361.46
Rate for Payer: UnitedHealthcare Community & State	$58.07
Rate for Payer: Wellpoint Medicaid Managed Care	$63.86

PLUG CANN D=8 L=16MM

Facility

$2,409.75

Service Code	HCPCS C1889
Hospital Charge Code	270704122
Hospital Revenue Code	278
Min. Negotiated Rate	$361.46
Max. Negotiated Rate	$583.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$481.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$530.14
Rate for Payer: Qualcare PPO/HMO/WC	$361.46

PLUG CATH

Facility

$9.65

Hospital Charge Code	270300436
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

PLUG CATH

Facility

$9.65

Hospital Charge Code	270300436
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

PLUG DOWEL CANCELLOUS 10X 16MM

Facility

$2,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270684095
Hospital Revenue Code	278
Min. Negotiated Rate	$55.31
Max. Negotiated Rate	$1,147.50
Rate for Payer: Aetna Commercial	$872.10
Rate for Payer: Aetna Medicare Advantage	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$585.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$585.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$585.23
Rate for Payer: Cigna Commercial	$1,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$504.90
Rate for Payer: Qualcare PPO/HMO/WC	$344.25
Rate for Payer: UnitedHealthcare Community & State	$55.31
Rate for Payer: Wellpoint Medicaid Managed Care	$60.82

PLUG DOWEL CANCELLOUS 10X 16MM

Facility

$2,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270684095
Hospital Revenue Code	278
Min. Negotiated Rate	$344.25
Max. Negotiated Rate	$555.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$504.90
Rate for Payer: Qualcare PPO/HMO/WC	$344.25

PLUG DOWEL CANCELLOUS 11X 16MM

Facility

$2,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270684096
Hospital Revenue Code	278
Min. Negotiated Rate	$55.31
Max. Negotiated Rate	$1,147.50
Rate for Payer: Aetna Commercial	$872.10
Rate for Payer: Aetna Medicare Advantage	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$585.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$585.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$585.23
Rate for Payer: Cigna Commercial	$1,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$504.90
Rate for Payer: Qualcare PPO/HMO/WC	$344.25
Rate for Payer: UnitedHealthcare Community & State	$55.31
Rate for Payer: Wellpoint Medicaid Managed Care	$60.82

PLUG DOWEL CANCELLOUS 11X 16MM

Facility

$2,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270684096
Hospital Revenue Code	278
Min. Negotiated Rate	$344.25
Max. Negotiated Rate	$555.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$504.90
Rate for Payer: Qualcare PPO/HMO/WC	$344.25

PLUG DOWEL CANCELLOUS 7MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689469
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

PLUG DOWEL CANCELLOUS 7MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689469
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

PLUG DOWEL CANCELLOUS 8MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689470
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

PLUG DOWEL CANCELLOUS 8MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689470
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

Know your out-of-pocket cost for care.

All Charges