Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FEMUR ADVANCE PRIM POR LT SZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697443
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
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
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

FEMUR ADVANCE PRIM POR LT SZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697443
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

FEMUR ADVANCE PRI NONPOR LTSZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697442
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
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
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

FEMUR ADVANCE PRI NONPOR LTSZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697442
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

FEMUR ADVANCE STATUR PF LT SZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697444
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
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
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

FEMUR ADVANCE STATUR PF LT SZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697444
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

FEMUR AP& LAT-BILAT

Facility

$250.00

Hospital Charge Code	94061235
Hospital Revenue Code	320
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

FEMUR AP& LAT-BILAT

Facility

$250.00

Hospital Charge Code	94061235
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FEMUR AP& LAT-LT

Facility

$307.00

Hospital Charge Code	94061361
Hospital Revenue Code	320
Min. Negotiated Rate	$46.05
Max. Negotiated Rate	$46.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.05

FEMUR AP& LAT-LT

Facility

$307.00

Hospital Charge Code	94061361
Hospital Revenue Code	320
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$116.66
Rate for Payer: Aetna Medicare Advantage	$92.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.28
Rate for Payer: Cigna Commercial	$153.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.05
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

FEMUR AP& LAT-RT

Facility

$307.00

Hospital Charge Code	94061363
Hospital Revenue Code	320
Min. Negotiated Rate	$46.05
Max. Negotiated Rate	$46.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.05

FEMUR AP& LAT-RT

Facility

$307.00

Hospital Charge Code	94061363
Hospital Revenue Code	320
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$116.66
Rate for Payer: Aetna Medicare Advantage	$92.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.28
Rate for Payer: Cigna Commercial	$153.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.05
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

FEMUR AVENIR CMPL HA STD SZ 5

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695050
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

FEMUR AVENIR CMPL HA STD SZ 5

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695050
Hospital Revenue Code	278
Min. Negotiated Rate	$356.38
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$5,619.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13
Rate for Payer: UnitedHealthcare Community & State	$356.38
Rate for Payer: Wellpoint Medicaid Managed Care	$391.87

FEMUR AVENIR COMPLETE HA SZ 2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270698038
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

FEMUR AVENIR COMPLETE HA SZ 2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270698038
Hospital Revenue Code	278
Min. Negotiated Rate	$356.38
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$5,619.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13
Rate for Payer: UnitedHealthcare Community & State	$356.38
Rate for Payer: Wellpoint Medicaid Managed Care	$391.87

FEMUR AVENIR COMPLETE HA SZ 6

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270697997
Hospital Revenue Code	278
Min. Negotiated Rate	$356.38
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$5,619.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13
Rate for Payer: UnitedHealthcare Community & State	$356.38
Rate for Payer: Wellpoint Medicaid Managed Care	$391.87

FEMUR AVENIR COMPLETE HA SZ 6

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270697997
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

FEMUR AVENIR COPL HA HO COL

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270697932
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

FEMUR AVENIR COPL HA HO COL

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270697932
Hospital Revenue Code	278
Min. Negotiated Rate	$356.38
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$5,619.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13
Rate for Payer: UnitedHealthcare Community & State	$356.38
Rate for Payer: Wellpoint Medicaid Managed Care	$391.87

FEMUR AXIAL PIN ELEOS SZ 2

Facility

$11,025.00

Service Code	HCPCS C1776
Hospital Charge Code	270682841
Hospital Revenue Code	278
Min. Negotiated Rate	$265.70
Max. Negotiated Rate	$5,512.50
Rate for Payer: Aetna Commercial	$4,189.50
Rate for Payer: Aetna Medicare Advantage	$3,307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,811.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,811.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,811.38
Rate for Payer: Cigna Commercial	$5,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,668.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,425.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,653.75
Rate for Payer: UnitedHealthcare Community & State	$265.70
Rate for Payer: Wellpoint Medicaid Managed Care	$292.16

FEMUR AXIAL PIN ELEOS SZ 2

Facility

$11,025.00

Service Code	HCPCS C1776
Hospital Charge Code	270682841
Hospital Revenue Code	278
Min. Negotiated Rate	$1,653.75
Max. Negotiated Rate	$2,668.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,668.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,425.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,653.75

FEMUR BMT LEFT 70 140073

Facility

$7,916.85

Hospital Charge Code	270606915
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.53
Max. Negotiated Rate	$1,915.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,741.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.53

FEMUR BMT LEFT 70 140073

Facility

$7,916.85

Hospital Charge Code	270606915
Hospital Revenue Code	278
Min. Negotiated Rate	$190.80
Max. Negotiated Rate	$3,958.43
Rate for Payer: Aetna Commercial	$3,008.40
Rate for Payer: Aetna Medicare Advantage	$2,375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,018.80
Rate for Payer: Cigna Commercial	$3,958.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,741.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.53
Rate for Payer: UnitedHealthcare Community & State	$190.80
Rate for Payer: Wellpoint Medicaid Managed Care	$209.80

FEMUR BMT P S 60 L 145131

Facility

$6,630.45

Hospital Charge Code	270606311
Hospital Revenue Code	278
Min. Negotiated Rate	$159.79
Max. Negotiated Rate	$3,315.22
Rate for Payer: Aetna Commercial	$2,519.57
Rate for Payer: Aetna Medicare Advantage	$1,989.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,690.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,690.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,690.76
Rate for Payer: Cigna Commercial	$3,315.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,604.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,458.70
Rate for Payer: Qualcare PPO/HMO/WC	$994.57
Rate for Payer: UnitedHealthcare Community & State	$159.79
Rate for Payer: Wellpoint Medicaid Managed Care	$175.71

Know your out-of-pocket cost for care.

All Charges