Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FEMORAL HEAD COCR 32MM/+3.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669110
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/-3.5

Facility

$1,795.00

Hospital Charge Code	270669113
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

FEMORAL HEAD COCR 32MM/-3.5

Facility

$1,795.00

Hospital Charge Code	270669113
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/+7

Facility

$1,795.00

Hospital Charge Code	270669111
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/+7

Facility

$1,795.00

Hospital Charge Code	270669111
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

FEMORAL HEAD COCR -3.5MM 28MM

Facility

$2,175.00

Hospital Charge Code	270669543
Hospital Revenue Code	278
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$52.42
Rate for Payer: Wellpoint Medicaid Managed Care	$57.64

FEMORAL HEAD COCR -3.5MM 28MM

Facility

$2,175.00

Hospital Charge Code	270669543
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

FEMORAL HEAD COCR 3.5MM 36MM

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270669368
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

FEMORAL HEAD COCR 3.5MM 36MM

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270669368
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

FEMORAL HEAD COCR 36MM/0

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669114
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

FEMORAL HEAD COCR 36MM/0

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669114
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 36MM/+10.5

Facility

$1,795.00

Hospital Charge Code	270669118
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 36MM/+10.5

Facility

$1,795.00

Hospital Charge Code	270669118
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

FEMORAL HEAD COCR 36MM/+3.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669115
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 36MM/+3.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669115
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

FEMORAL HEAD COCR 36MM/-3.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669119
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 36MM/-3.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669119
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

FEMORAL HEAD COCR 36MM/+7

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669116
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

FEMORAL HEAD COCR 36MM/+7

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669116
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.90
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 40MM/0

Facility

$2,255.00

Hospital Charge Code	270669120
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

FEMORAL HEAD COCR 40MM/0

Facility

$2,255.00

Hospital Charge Code	270669120
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

FEMORAL HEAD COCR 40MM/+10.5

Facility

$2,255.00

Hospital Charge Code	270669123
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

FEMORAL HEAD COCR 40MM/+10.5

Facility

$2,255.00

Hospital Charge Code	270669123
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

FEMORAL HEAD COCR 40MM/+3.5

Facility

$2,255.00

Hospital Charge Code	270669121
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

FEMORAL HEAD COCR 40MM/+3.5

Facility

$2,255.00

Hospital Charge Code	270669121
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

Know your out-of-pocket cost for care.

All Charges