Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLUG DOWEL CANCELLOUS 9MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689471
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 9MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689471
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 HERNIA MESH SMPL-01

Facility

$519.25

Hospital Charge Code	270622475
Hospital Revenue Code	278
Min. Negotiated Rate	$77.89
Max. Negotiated Rate	$125.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.23
Rate for Payer: Qualcare PPO/HMO/WC	$77.89

PLUG HERNIA MESH SMPL-01

Facility

$519.25

Hospital Charge Code	270622475
Hospital Revenue Code	278
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.62
Rate for Payer: Aetna Commercial	$197.31
Rate for Payer: Aetna Medicare Advantage	$155.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.41
Rate for Payer: Cigna Commercial	$259.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.23
Rate for Payer: Qualcare PPO/HMO/WC	$77.89
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.76

PLUG INTRAMEDULLARY LG

Facility

$895.00

Service Code	HCPCS C1713
Hospital Charge Code	270605341
Hospital Revenue Code	278
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$447.50
Rate for Payer: Aetna Commercial	$340.10
Rate for Payer: Aetna Medicare Advantage	$268.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.22
Rate for Payer: Cigna Commercial	$447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$134.25
Rate for Payer: UnitedHealthcare Community & State	$21.57
Rate for Payer: Wellpoint Medicaid Managed Care	$23.72

PLUG INTRAMEDULLARY LG

Facility

$895.00

Service Code	HCPCS C1713
Hospital Charge Code	270605341
Hospital Revenue Code	278
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$216.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

PLUG MESH PROLOOP MED

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270653937
Hospital Revenue Code	278
Min. Negotiated Rate	$16.24
Max. Negotiated Rate	$336.88
Rate for Payer: Aetna Commercial	$256.02
Rate for Payer: Aetna Medicare Advantage	$202.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.81
Rate for Payer: Cigna Commercial	$336.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$101.06
Rate for Payer: UnitedHealthcare Community & State	$16.24
Rate for Payer: Wellpoint Medicaid Managed Care	$17.85

PLUG MESH PROLOOP MED

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270653937
Hospital Revenue Code	278
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$163.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$101.06

PLUG MESH PROLOOP MEDIUM 13704

Facility

$622.30

Service Code	HCPCS C1781
Hospital Charge Code	270651873
Hospital Revenue Code	278
Min. Negotiated Rate	$93.34
Max. Negotiated Rate	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.91
Rate for Payer: Qualcare PPO/HMO/WC	$93.34

PLUG MESH PROLOOP MEDIUM 13704

Facility

$622.30

Service Code	HCPCS C1781
Hospital Charge Code	270651873
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$311.15
Rate for Payer: Aetna Commercial	$236.47
Rate for Payer: Aetna Medicare Advantage	$186.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.69
Rate for Payer: Cigna Commercial	$311.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.91
Rate for Payer: Qualcare PPO/HMO/WC	$93.34
Rate for Payer: UnitedHealthcare Community & State	$15.00
Rate for Payer: Wellpoint Medicaid Managed Care	$16.49

PLUG MESH PROLOOP SMALL

Facility

$622.30

Service Code	HCPCS C1781
Hospital Charge Code	270651874
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$311.15
Rate for Payer: Aetna Commercial	$236.47
Rate for Payer: Aetna Medicare Advantage	$186.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.69
Rate for Payer: Cigna Commercial	$311.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.91
Rate for Payer: Qualcare PPO/HMO/WC	$93.34
Rate for Payer: UnitedHealthcare Community & State	$15.00
Rate for Payer: Wellpoint Medicaid Managed Care	$16.49

PLUG MESH PROLOOP SMALL

Facility

$622.30

Service Code	HCPCS C1781
Hospital Charge Code	270651874
Hospital Revenue Code	278
Min. Negotiated Rate	$93.34
Max. Negotiated Rate	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.91
Rate for Payer: Qualcare PPO/HMO/WC	$93.34

PLUG MESH PROLOOP XL

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270651876
Hospital Revenue Code	278
Min. Negotiated Rate	$16.24
Max. Negotiated Rate	$336.88
Rate for Payer: Aetna Commercial	$256.02
Rate for Payer: Aetna Medicare Advantage	$202.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.81
Rate for Payer: Cigna Commercial	$336.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$101.06
Rate for Payer: UnitedHealthcare Community & State	$16.24
Rate for Payer: Wellpoint Medicaid Managed Care	$17.85

PLUG MESH PROLOOP XL

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270651876
Hospital Revenue Code	278
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$163.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$101.06

PLUG PERFIX MESH *******

Facility

$281.00

Hospital Charge Code	1608348
Hospital Revenue Code	272
Min. Negotiated Rate	$6.77
Max. Negotiated Rate	$140.50
Rate for Payer: Aetna Commercial	$106.78
Rate for Payer: Aetna Medicare Advantage	$84.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.66
Rate for Payer: Cigna Commercial	$140.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.30
Rate for Payer: Oxford Commercial	$56.20
Rate for Payer: Qualcare PPO/HMO/WC	$42.15
Rate for Payer: UnitedHealthcare Commercial	$56.20
Rate for Payer: UnitedHealthcare Community & State	$6.77
Rate for Payer: Wellpoint Medicaid Managed Care	$7.45

PLUG PERFIX MESH *******

Facility

$281.00

Hospital Charge Code	1608348
Hospital Revenue Code	272
Min. Negotiated Rate	$42.15
Max. Negotiated Rate	$42.15
Rate for Payer: Qualcare PPO/HMO/WC	$42.15

PLUG POLY****

Facility

$247.00

Hospital Charge Code	1601772
Hospital Revenue Code	272
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$123.50
Rate for Payer: Aetna Commercial	$93.86
Rate for Payer: Aetna Medicare Advantage	$74.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.98
Rate for Payer: Cigna Commercial	$123.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.10
Rate for Payer: Oxford Commercial	$49.40
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$49.40
Rate for Payer: UnitedHealthcare Community & State	$5.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.55

PLUG POLY****

Facility

$247.00

Hospital Charge Code	1601772
Hospital Revenue Code	272
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

PLUG SDK BREAKOFF SCREW 859855

Facility

$890.45

Hospital Charge Code	270616993
Hospital Revenue Code	278
Min. Negotiated Rate	$133.57
Max. Negotiated Rate	$215.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.57

PLUG SDK BREAKOFF SCREW 859855

Facility

$890.45

Hospital Charge Code	270616993
Hospital Revenue Code	278
Min. Negotiated Rate	$21.46
Max. Negotiated Rate	$445.23
Rate for Payer: Aetna Commercial	$338.37
Rate for Payer: Aetna Medicare Advantage	$267.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.06
Rate for Payer: Cigna Commercial	$445.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.57
Rate for Payer: UnitedHealthcare Community & State	$21.46
Rate for Payer: Wellpoint Medicaid Managed Care	$23.60

PLUG SURGISIS ANAL FISTULA

Facility

$4,250.00

Hospital Charge Code	270637927
Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

PLUG SURGISIS ANAL FISTULA

Facility

$4,250.00

Hospital Charge Code	270637927
Hospital Revenue Code	272
Min. Negotiated Rate	$102.42
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,275.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$850.00
Rate for Payer: UnitedHealthcare Community & State	$102.42
Rate for Payer: Wellpoint Medicaid Managed Care	$112.62

PLUG TRUFILL BCA LIQ 1GM

Facility

$23,754.00

Hospital Charge Code	270696473S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,563.10
Max. Negotiated Rate	$5,748.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,748.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,225.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,563.10

PLUG TRUFILL BCA LIQ 1GM

Facility

$23,754.00

Hospital Charge Code	270696473S
Hospital Revenue Code	278
Min. Negotiated Rate	$572.47
Max. Negotiated Rate	$11,877.00
Rate for Payer: Aetna Commercial	$9,026.52
Rate for Payer: Aetna Medicare Advantage	$7,126.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,057.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,057.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,057.27
Rate for Payer: Cigna Commercial	$11,877.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,748.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,225.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,563.10
Rate for Payer: UnitedHealthcare Community & State	$572.47
Rate for Payer: Wellpoint Medicaid Managed Care	$629.48

PLUME AWAY

Facility

$199.84

Hospital Charge Code	270663223
Hospital Revenue Code	270
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$99.92
Rate for Payer: Aetna Commercial	$75.94
Rate for Payer: Aetna Medicare Advantage	$59.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.96
Rate for Payer: Cigna Commercial	$99.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.95
Rate for Payer: Oxford Commercial	$39.97
Rate for Payer: Qualcare PPO/HMO/WC	$29.98
Rate for Payer: UnitedHealthcare Commercial	$39.97
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

Know your out-of-pocket cost for care.

All Charges