Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FEM HEAD CERAM C-TPR 2.5X36MM

Facility

$4,799.25

Service Code	HCPCS C1776
Hospital Charge Code	270693125
Hospital Revenue Code	278
Min. Negotiated Rate	$719.89
Max. Negotiated Rate	$1,161.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$959.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,055.84
Rate for Payer: Qualcare PPO/HMO/WC	$719.89

FEM HEAD CERAM C-TPR 2.5X36MM

Facility

$4,799.25

Service Code	HCPCS C1776
Hospital Charge Code	270693125
Hospital Revenue Code	278
Min. Negotiated Rate	$115.66
Max. Negotiated Rate	$2,399.62
Rate for Payer: Aetna Commercial	$1,823.71
Rate for Payer: Aetna Medicare Advantage	$1,439.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,223.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,223.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$959.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,223.81
Rate for Payer: Cigna Commercial	$2,399.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,055.84
Rate for Payer: Qualcare PPO/HMO/WC	$719.89
Rate for Payer: UnitedHealthcare Community & State	$115.66
Rate for Payer: Wellpoint Medicaid Managed Care	$127.18

FEM HEAD CER BIOLOX S TAP 28MM

Facility

$9,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270694816
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.50
Max. Negotiated Rate	$2,417.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,197.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50

FEM HEAD CER BIOLOX S TAP 28MM

Facility

$9,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270694816
Hospital Revenue Code	278
Min. Negotiated Rate	$240.76
Max. Negotiated Rate	$4,995.00
Rate for Payer: Aetna Commercial	$3,796.20
Rate for Payer: Aetna Medicare Advantage	$2,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,547.45
Rate for Payer: Cigna Commercial	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,197.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50
Rate for Payer: UnitedHealthcare Community & State	$240.76
Rate for Payer: Wellpoint Medicaid Managed Care	$264.74

FEM NAIL RETRO 10.5MM X 300MM

Facility

$7,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270681041
Hospital Revenue Code	278
Min. Negotiated Rate	$182.20
Max. Negotiated Rate	$3,780.00
Rate for Payer: Aetna Commercial	$2,872.80
Rate for Payer: Aetna Medicare Advantage	$2,268.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,927.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,927.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,927.80
Rate for Payer: Cigna Commercial	$3,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,829.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,663.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.00
Rate for Payer: UnitedHealthcare Community & State	$182.20
Rate for Payer: Wellpoint Medicaid Managed Care	$200.34

FEM NAIL RETRO 10.5MM X 300MM

Facility

$7,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270681041
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.00
Max. Negotiated Rate	$1,829.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,829.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,663.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.00

FEM NAIL RETRO 13.5MMX380MM

Facility

$8,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270691622
Hospital Revenue Code	278
Min. Negotiated Rate	$1,226.25
Max. Negotiated Rate	$1,978.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,978.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,798.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,226.25

FEM NAIL RETRO 13.5MMX380MM

Facility

$8,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270691622
Hospital Revenue Code	278
Min. Negotiated Rate	$197.02
Max. Negotiated Rate	$4,087.50
Rate for Payer: Aetna Commercial	$3,106.50
Rate for Payer: Aetna Medicare Advantage	$2,452.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,084.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,084.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,084.62
Rate for Payer: Cigna Commercial	$4,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,978.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,798.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,226.25
Rate for Payer: UnitedHealthcare Community & State	$197.02
Rate for Payer: Wellpoint Medicaid Managed Care	$216.64

FEM NEXG KNEE LPS OPT 59961551

Facility

$12,529.20

Hospital Charge Code	270642103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,879.38
Max. Negotiated Rate	$3,032.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,505.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,032.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,756.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,879.38

FEM NEXG KNEE LPS OPT 59961551

Facility

$12,529.20

Hospital Charge Code	270642103
Hospital Revenue Code	278
Min. Negotiated Rate	$301.95
Max. Negotiated Rate	$6,264.60
Rate for Payer: Aetna Commercial	$4,761.10
Rate for Payer: Aetna Medicare Advantage	$3,758.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,194.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,194.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,505.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,194.95
Rate for Payer: Cigna Commercial	$6,264.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,032.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,756.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,879.38
Rate for Payer: UnitedHealthcare Community & State	$301.95
Rate for Payer: Wellpoint Medicaid Managed Care	$332.02

FEM NEX KNE CR SZ C LT59721301

Facility

$13,667.00

Hospital Charge Code	270634980
Hospital Revenue Code	278
Min. Negotiated Rate	$329.37
Max. Negotiated Rate	$6,833.50
Rate for Payer: Aetna Commercial	$5,193.46
Rate for Payer: Aetna Medicare Advantage	$4,100.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,485.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,485.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,733.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,485.09
Rate for Payer: Cigna Commercial	$6,833.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,307.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,006.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,050.05
Rate for Payer: UnitedHealthcare Community & State	$329.37
Rate for Payer: Wellpoint Medicaid Managed Care	$362.18

FEM NEX KNE CR SZ C LT59721301

Facility

$13,667.00

Hospital Charge Code	270634980
Hospital Revenue Code	278
Min. Negotiated Rate	$2,050.05
Max. Negotiated Rate	$3,307.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,733.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,307.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,006.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,050.05

FEM NEX KNE CR SZ C RT59721302

Facility

$13,667.00

Hospital Charge Code	270634981
Hospital Revenue Code	278
Min. Negotiated Rate	$2,050.05
Max. Negotiated Rate	$3,307.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,733.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,307.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,006.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,050.05

FEM NEX KNE CR SZ C RT59721302

Facility

$13,667.00

Hospital Charge Code	270634981
Hospital Revenue Code	278
Min. Negotiated Rate	$329.37
Max. Negotiated Rate	$6,833.50
Rate for Payer: Aetna Commercial	$5,193.46
Rate for Payer: Aetna Medicare Advantage	$4,100.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,485.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,485.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,733.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,485.09
Rate for Payer: Cigna Commercial	$6,833.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,307.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,006.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,050.05
Rate for Payer: UnitedHealthcare Community & State	$329.37
Rate for Payer: Wellpoint Medicaid Managed Care	$362.18

FEM NEX KNEE LPS OPT 59961552

Facility

$12,047.30

Hospital Charge Code	270639170
Hospital Revenue Code	278
Min. Negotiated Rate	$290.34
Max. Negotiated Rate	$6,023.65
Rate for Payer: Aetna Commercial	$4,577.97
Rate for Payer: Aetna Medicare Advantage	$3,614.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,072.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,072.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,072.06
Rate for Payer: Cigna Commercial	$6,023.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,915.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,650.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,807.10
Rate for Payer: UnitedHealthcare Community & State	$290.34
Rate for Payer: Wellpoint Medicaid Managed Care	$319.25

FEM NEX KNEE LPS OPT 59961552

Facility

$12,047.30

Hospital Charge Code	270639170
Hospital Revenue Code	278
Min. Negotiated Rate	$1,807.10
Max. Negotiated Rate	$2,915.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,915.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,650.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,807.10

FEMORAL ANGIOGRAM

Facility

$6,122.00

Service Code	HCPCS 75710
Hospital Charge Code	7411147
Hospital Revenue Code	323
Min. Negotiated Rate	$146.36
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

FEMORAL ANGIOGRAM

Facility

$6,122.00

Service Code	HCPCS 75710
Hospital Charge Code	7411147
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

FEMORAL ASYM POST STAB SZ 3 LF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270670657
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

FEMORAL ASYM POST STAB SZ 3 LF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270670657
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

FEMORAL ASYM POST STAB SZ5 LF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672125
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

FEMORAL ASYM POST STAB SZ5 LF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672125
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

FEMORAL ASYM POST SZ2 RIGHT

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270669782
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

FEMORAL ASYM POST SZ2 RIGHT

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270669782
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

FEMORAL ATTUNE POST STAB SZ 4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

Know your out-of-pocket cost for care.

All Charges