Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

T-PLATE 4 HOLE 20MM CLAW II

Facility

$8,715.00

Hospital Charge Code	270665926
Hospital Revenue Code	278
Min. Negotiated Rate	$210.03
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$3,311.70
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,917.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25
Rate for Payer: UnitedHealthcare Community & State	$210.03
Rate for Payer: Wellpoint Medicaid Managed Care	$230.95

T-PLATE 4 HOLE 25MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270673663
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$2,109.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,917.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

T-PLATE 4 HOLE 25MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270673663
Hospital Revenue Code	278
Min. Negotiated Rate	$210.03
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$3,311.70
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,917.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25
Rate for Payer: UnitedHealthcare Community & State	$210.03
Rate for Payer: Wellpoint Medicaid Managed Care	$230.95

T-PLATE 4 HOLE 30MM CLAW II

Facility

$8,715.00

Hospital Charge Code	270671024
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$2,109.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,917.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

T-PLATE 4 HOLE 30MM CLAW II

Facility

$8,715.00

Hospital Charge Code	270671024
Hospital Revenue Code	278
Min. Negotiated Rate	$210.03
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$3,311.70
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,917.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25
Rate for Payer: UnitedHealthcare Community & State	$210.03
Rate for Payer: Wellpoint Medicaid Managed Care	$230.95

T-PLATE 4HOLE 84MM

Facility

$1,248.35

Service Code	HCPCS C1713
Hospital Charge Code	270652907
Hospital Revenue Code	278
Min. Negotiated Rate	$30.09
Max. Negotiated Rate	$624.17
Rate for Payer: Aetna Commercial	$474.37
Rate for Payer: Aetna Medicare Advantage	$374.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.33
Rate for Payer: Cigna Commercial	$624.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$274.64
Rate for Payer: Qualcare PPO/HMO/WC	$187.25
Rate for Payer: UnitedHealthcare Community & State	$30.09
Rate for Payer: Wellpoint Medicaid Managed Care	$33.08

T-PLATE 4HOLE 84MM

Facility

$1,248.35

Service Code	HCPCS C1713
Hospital Charge Code	270652907
Hospital Revenue Code	278
Min. Negotiated Rate	$187.25
Max. Negotiated Rate	$302.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$274.64
Rate for Payer: Qualcare PPO/HMO/WC	$187.25

T-PLATE 4 HOLES

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270670803
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

T-PLATE 4 HOLES

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270670803
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

T-PLATE 5H RS

Facility

$5,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692249
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,232.00
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

T-PLATE 5H RS

Facility

$5,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692249
Hospital Revenue Code	278
Min. Negotiated Rate	$134.96
Max. Negotiated Rate	$2,800.00
Rate for Payer: Aetna Commercial	$2,128.00
Rate for Payer: Aetna Medicare Advantage	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,428.00
Rate for Payer: Cigna Commercial	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,232.00
Rate for Payer: Qualcare PPO/HMO/WC	$840.00
Rate for Payer: UnitedHealthcare Community & State	$134.96
Rate for Payer: Wellpoint Medicaid Managed Care	$148.40

T-PLATE LCP 2.0MM 2HOLE/9HOLE

Facility

$1,788.00

Service Code	HCPCS C1713
Hospital Charge Code	270659769
Hospital Revenue Code	278
Min. Negotiated Rate	$268.20
Max. Negotiated Rate	$432.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.36
Rate for Payer: Qualcare PPO/HMO/WC	$268.20

T-PLATE LCP 2.0MM 2HOLE/9HOLE

Facility

$1,788.00

Service Code	HCPCS C1713
Hospital Charge Code	270659769
Hospital Revenue Code	278
Min. Negotiated Rate	$43.09
Max. Negotiated Rate	$894.00
Rate for Payer: Aetna Commercial	$679.44
Rate for Payer: Aetna Medicare Advantage	$536.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.94
Rate for Payer: Cigna Commercial	$894.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.36
Rate for Payer: Qualcare PPO/HMO/WC	$268.20
Rate for Payer: UnitedHealthcare Community & State	$43.09
Rate for Payer: Wellpoint Medicaid Managed Care	$47.38

T-PLATE LCP 2.4MM 3HOLE/7HOLE

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270676530
Hospital Revenue Code	278
Min. Negotiated Rate	$458.87
Max. Negotiated Rate	$740.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$458.87

T-PLATE LCP 2.4MM 3HOLE/7HOLE

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270676530
Hospital Revenue Code	278
Min. Negotiated Rate	$73.72
Max. Negotiated Rate	$1,529.55
Rate for Payer: Aetna Commercial	$1,162.46
Rate for Payer: Aetna Medicare Advantage	$917.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.07
Rate for Payer: Cigna Commercial	$1,529.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$458.87
Rate for Payer: UnitedHealthcare Community & State	$73.72
Rate for Payer: Wellpoint Medicaid Managed Care	$81.07

T-PLATE LCP 2 HOLE 2.7MM

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270678174
Hospital Revenue Code	278
Min. Negotiated Rate	$458.87
Max. Negotiated Rate	$740.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$458.87

T-PLATE LCP 2 HOLE 2.7MM

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270678174
Hospital Revenue Code	278
Min. Negotiated Rate	$73.72
Max. Negotiated Rate	$1,529.55
Rate for Payer: Aetna Commercial	$1,162.46
Rate for Payer: Aetna Medicare Advantage	$917.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.07
Rate for Payer: Cigna Commercial	$1,529.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$458.87
Rate for Payer: UnitedHealthcare Community & State	$73.72
Rate for Payer: Wellpoint Medicaid Managed Care	$81.07

T-PLATE LCP 3.5x52MM 3H/3H RT

Facility

$1,546.80

Service Code	HCPCS C1713
Hospital Charge Code	270656698
Hospital Revenue Code	278
Min. Negotiated Rate	$232.02
Max. Negotiated Rate	$374.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$340.30
Rate for Payer: Qualcare PPO/HMO/WC	$232.02

T-PLATE LCP 3.5x52MM 3H/3H RT

Facility

$1,546.80

Service Code	HCPCS C1713
Hospital Charge Code	270656698
Hospital Revenue Code	278
Min. Negotiated Rate	$37.28
Max. Negotiated Rate	$773.40
Rate for Payer: Aetna Commercial	$587.78
Rate for Payer: Aetna Medicare Advantage	$464.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.43
Rate for Payer: Cigna Commercial	$773.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$340.30
Rate for Payer: Qualcare PPO/HMO/WC	$232.02
Rate for Payer: UnitedHealthcare Community & State	$37.28
Rate for Payer: Wellpoint Medicaid Managed Care	$40.99

T-PLATE LCP 3.5x56MM 4H/4H RT

Facility

$1,384.30

Hospital Charge Code	270675318
Hospital Revenue Code	278
Min. Negotiated Rate	$33.36
Max. Negotiated Rate	$692.15
Rate for Payer: Aetna Commercial	$526.03
Rate for Payer: Aetna Medicare Advantage	$415.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.00
Rate for Payer: Cigna Commercial	$692.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.55
Rate for Payer: Qualcare PPO/HMO/WC	$207.65
Rate for Payer: UnitedHealthcare Community & State	$33.36
Rate for Payer: Wellpoint Medicaid Managed Care	$36.68

T-PLATE LCP 3.5x56MM 4H/4H RT

Facility

$1,384.30

Hospital Charge Code	270675318
Hospital Revenue Code	278
Min. Negotiated Rate	$207.65
Max. Negotiated Rate	$335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.55
Rate for Payer: Qualcare PPO/HMO/WC	$207.65

T-PLATE LCP 3.5x63MM 3H/4H RT

Facility

$1,569.70

Hospital Charge Code	270656699
Hospital Revenue Code	278
Min. Negotiated Rate	$37.83
Max. Negotiated Rate	$784.85
Rate for Payer: Aetna Commercial	$596.49
Rate for Payer: Aetna Medicare Advantage	$470.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.27
Rate for Payer: Cigna Commercial	$784.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.33
Rate for Payer: Qualcare PPO/HMO/WC	$235.46
Rate for Payer: UnitedHealthcare Community & State	$37.83
Rate for Payer: Wellpoint Medicaid Managed Care	$41.60

T-PLATE LCP 3.5x63MM 3H/4H RT

Facility

$1,569.70

Hospital Charge Code	270656699
Hospital Revenue Code	278
Min. Negotiated Rate	$235.46
Max. Negotiated Rate	$379.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.33
Rate for Payer: Qualcare PPO/HMO/WC	$235.46

T-PLATE LCP 3.5x78MM 4H/6H RT

Facility

$1,773.65

Hospital Charge Code	270656700
Hospital Revenue Code	278
Min. Negotiated Rate	$266.05
Max. Negotiated Rate	$429.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.20
Rate for Payer: Qualcare PPO/HMO/WC	$266.05

T-PLATE LCP 3.5x78MM 4H/6H RT

Facility

$1,773.65

Hospital Charge Code	270656700
Hospital Revenue Code	278
Min. Negotiated Rate	$42.74
Max. Negotiated Rate	$886.83
Rate for Payer: Aetna Commercial	$673.99
Rate for Payer: Aetna Medicare Advantage	$532.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.28
Rate for Payer: Cigna Commercial	$886.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.20
Rate for Payer: Qualcare PPO/HMO/WC	$266.05
Rate for Payer: UnitedHealthcare Community & State	$42.74
Rate for Payer: Wellpoint Medicaid Managed Care	$47.00

Know your out-of-pocket cost for care.

All Charges