Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FEMUR BMT P S 60 L 145131

Facility

$6,630.45

Hospital Charge Code	270606311
Hospital Revenue Code	278
Min. Negotiated Rate	$994.57
Max. Negotiated Rate	$1,604.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.09
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

FEMUR BMT RT 60 145151

Facility

$13,420.00

Hospital Charge Code	270628841
Hospital Revenue Code	278
Min. Negotiated Rate	$323.42
Max. Negotiated Rate	$6,710.00
Rate for Payer: Aetna Commercial	$5,099.60
Rate for Payer: Aetna Medicare Advantage	$4,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,422.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,422.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,422.10
Rate for Payer: Cigna Commercial	$6,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,247.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,952.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,013.00
Rate for Payer: UnitedHealthcare Community & State	$323.42
Rate for Payer: Wellpoint Medicaid Managed Care	$355.63

FEMUR BMT RT 60 145151

Facility

$13,420.00

Hospital Charge Code	270628841
Hospital Revenue Code	278
Min. Negotiated Rate	$2,013.00
Max. Negotiated Rate	$3,247.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,684.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,247.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,952.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,013.00

FEMUR BONE

Facility

$500.00

Hospital Charge Code	270671826
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

FEMUR BONE

Facility

$500.00

Hospital Charge Code	270671826
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

FEMUR BONE MODEL LEFT

Facility

$500.00

Hospital Charge Code	270673960
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

FEMUR BONE MODEL LEFT

Facility

$500.00

Hospital Charge Code	270673960
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

FEMUR CEMENTED RIGHT SZ 6 STD

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689504
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

FEMUR CEMENTED RIGHT SZ 6 STD

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689504
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

FEMUR CEMENTED STD SZ 9

Facility

$53,215.00

Service Code	HCPCS C1776
Hospital Charge Code	270699093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,282.48
Max. Negotiated Rate	$26,607.50
Rate for Payer: Aetna Commercial	$20,221.70
Rate for Payer: Aetna Medicare Advantage	$15,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,569.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,569.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,643.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,569.83
Rate for Payer: Cigna Commercial	$26,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,878.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,707.30
Rate for Payer: Qualcare PPO/HMO/WC	$7,982.25
Rate for Payer: UnitedHealthcare Community & State	$1,282.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1,410.20

FEMUR CEMENTED STD SZ 9

Facility

$53,215.00

Service Code	HCPCS C1776
Hospital Charge Code	270699093
Hospital Revenue Code	278
Min. Negotiated Rate	$7,982.25
Max. Negotiated Rate	$12,878.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,643.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,878.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,707.30
Rate for Payer: Qualcare PPO/HMO/WC	$7,982.25

FEMUR CEMENTED STD SZ 9 LEFT

Facility

$53,215.00

Hospital Charge Code	270702033
Hospital Revenue Code	278
Min. Negotiated Rate	$7,982.25
Max. Negotiated Rate	$12,878.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,643.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,878.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,707.30
Rate for Payer: Qualcare PPO/HMO/WC	$7,982.25

FEMUR CEMENTED STD SZ 9 LEFT

Facility

$53,215.00

Hospital Charge Code	270702033
Hospital Revenue Code	278
Min. Negotiated Rate	$1,282.48
Max. Negotiated Rate	$26,607.50
Rate for Payer: Aetna Commercial	$20,221.70
Rate for Payer: Aetna Medicare Advantage	$15,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,569.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,569.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,643.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,569.83
Rate for Payer: Cigna Commercial	$26,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,878.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,707.30
Rate for Payer: Qualcare PPO/HMO/WC	$7,982.25
Rate for Payer: UnitedHealthcare Community & State	$1,282.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1,410.20

FEMUR COMPONENT

Facility

$12,166.15

Hospital Charge Code	270657025
Hospital Revenue Code	278
Min. Negotiated Rate	$293.20
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$4,623.14
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92
Rate for Payer: UnitedHealthcare Community & State	$293.20
Rate for Payer: Wellpoint Medicaid Managed Care	$322.40

FEMUR COMPONENT

Facility

$12,166.15

Hospital Charge Code	270657025
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

FEMUR CR INTERLOC 62.5R 183006

Facility

$14,620.00

Hospital Charge Code	270640105
Hospital Revenue Code	278
Min. Negotiated Rate	$2,193.00
Max. Negotiated Rate	$3,538.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,924.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,538.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,216.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,193.00

FEMUR CR INTERLOC 62.5R 183006

Facility

$14,620.00

Hospital Charge Code	270640105
Hospital Revenue Code	278
Min. Negotiated Rate	$352.34
Max. Negotiated Rate	$7,310.00
Rate for Payer: Aetna Commercial	$5,555.60
Rate for Payer: Aetna Medicare Advantage	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,728.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,728.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,924.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,728.10
Rate for Payer: Cigna Commercial	$7,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,538.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,216.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,193.00
Rate for Payer: UnitedHealthcare Community & State	$352.34
Rate for Payer: Wellpoint Medicaid Managed Care	$387.43

FEMUR CR PORO 62.5MM RT 183046

Facility

$17,420.00

Hospital Charge Code	270640576
Hospital Revenue Code	278
Min. Negotiated Rate	$419.82
Max. Negotiated Rate	$8,710.00
Rate for Payer: Aetna Commercial	$6,619.60
Rate for Payer: Aetna Medicare Advantage	$5,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,442.10
Rate for Payer: Cigna Commercial	$8,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,832.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00
Rate for Payer: UnitedHealthcare Community & State	$419.82
Rate for Payer: Wellpoint Medicaid Managed Care	$461.63

FEMUR CR PORO 62.5MM RT 183046

Facility

$17,420.00

Hospital Charge Code	270640576
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.00
Max. Negotiated Rate	$4,215.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,832.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00

FEMUR CR POROUS 65MM RT 183043

Facility

$17,420.00

Hospital Charge Code	270640543
Hospital Revenue Code	278
Min. Negotiated Rate	$419.82
Max. Negotiated Rate	$8,710.00
Rate for Payer: Aetna Commercial	$6,619.60
Rate for Payer: Aetna Medicare Advantage	$5,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,442.10
Rate for Payer: Cigna Commercial	$8,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,832.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00
Rate for Payer: UnitedHealthcare Community & State	$419.82
Rate for Payer: Wellpoint Medicaid Managed Care	$461.63

FEMUR CR POROUS 65MM RT 183043

Facility

$17,420.00

Hospital Charge Code	270640543
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.00
Max. Negotiated Rate	$4,215.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,832.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00

FEMUR CUTTING BLOCK FEMUR CUTT

Facility

$625.00

Hospital Charge Code	270678756
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

FEMUR CUTTING BLOCK FEMUR CUTT

Facility

$625.00

Hospital Charge Code	270678756
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

FEMUR CUTTING BLOCK LF SZ 3

Facility

$2,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270671829
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

FEMUR CUTTING BLOCK LF SZ 3

Facility

$2,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270671829
Hospital Revenue Code	278
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

Know your out-of-pocket cost for care.

All Charges