Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HIP STEM-LEFT HIP

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270677234
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$7,481.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,801.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

HIP STEM-LEFT HIP

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270677234
Hospital Revenue Code	278
Min. Negotiated Rate	$745.11
Max. Negotiated Rate	$15,458.62
Rate for Payer: Aetna Commercial	$11,748.56
Rate for Payer: Aetna Medicare Advantage	$9,275.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,883.90
Rate for Payer: Cigna Commercial	$15,458.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,801.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59
Rate for Payer: UnitedHealthcare Community & State	$745.11
Rate for Payer: Wellpoint Medicaid Managed Care	$819.31

HIP STEM NECK ANGLE SZ 0

Facility

$17,491.50

Hospital Charge Code	270676688
Hospital Revenue Code	278
Min. Negotiated Rate	$421.55
Max. Negotiated Rate	$8,745.75
Rate for Payer: Aetna Commercial	$6,646.77
Rate for Payer: Aetna Medicare Advantage	$5,247.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,460.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,460.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,498.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,460.33
Rate for Payer: Cigna Commercial	$8,745.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,232.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,848.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,623.72
Rate for Payer: UnitedHealthcare Community & State	$421.55
Rate for Payer: Wellpoint Medicaid Managed Care	$463.52

HIP STEM NECK ANGLE SZ 0

Facility

$17,491.50

Hospital Charge Code	270676688
Hospital Revenue Code	278
Min. Negotiated Rate	$2,623.72
Max. Negotiated Rate	$4,232.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,498.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,232.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,848.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,623.72

HIP STEM NECK ANGLE SZ4

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270671315
Hospital Revenue Code	278
Min. Negotiated Rate	$357.88
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$5,643.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50
Rate for Payer: UnitedHealthcare Community & State	$357.88
Rate for Payer: Wellpoint Medicaid Managed Care	$393.52

HIP STEM NECK ANGLE SZ4

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270671315
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

HIP STEM NECK ANG V40 SZ 4.5

Facility

$14,850.00

Hospital Charge Code	270669750
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

HIP STEM NECK ANG V40 SZ 4.5

Facility

$14,850.00

Hospital Charge Code	270669750
Hospital Revenue Code	278
Min. Negotiated Rate	$357.88
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$5,643.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50
Rate for Payer: UnitedHealthcare Community & State	$357.88
Rate for Payer: Wellpoint Medicaid Managed Care	$393.52

HIP STEM SZ 10/14 DISTAL DIA.

Facility

$36,738.00

Service Code	HCPCS C1776
Hospital Charge Code	270673915
Hospital Revenue Code	278
Min. Negotiated Rate	$5,510.70
Max. Negotiated Rate	$8,890.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,347.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,890.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,082.36
Rate for Payer: Qualcare PPO/HMO/WC	$5,510.70

HIP STEM SZ 10/14 DISTAL DIA.

Facility

$36,738.00

Service Code	HCPCS C1776
Hospital Charge Code	270673915
Hospital Revenue Code	278
Min. Negotiated Rate	$885.39
Max. Negotiated Rate	$18,369.00
Rate for Payer: Aetna Commercial	$13,960.44
Rate for Payer: Aetna Medicare Advantage	$11,021.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,368.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,368.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,347.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,368.19
Rate for Payer: Cigna Commercial	$18,369.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,890.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,082.36
Rate for Payer: Qualcare PPO/HMO/WC	$5,510.70
Rate for Payer: UnitedHealthcare Community & State	$885.39
Rate for Payer: Wellpoint Medicaid Managed Care	$973.56

HIP STEM SZ 3 NK LNTH 35MM

Facility

$14,850.00

Hospital Charge Code	270669391
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

HIP STEM SZ 3 NK LNTH 35MM

Facility

$14,850.00

Hospital Charge Code	270669391
Hospital Revenue Code	278
Min. Negotiated Rate	$357.88
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$5,643.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50
Rate for Payer: UnitedHealthcare Community & State	$357.88
Rate for Payer: Wellpoint Medicaid Managed Care	$393.52

HIP STEM SZ6 35 X 107 MM STD

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700800
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

HIP STEM SZ6 35 X 107 MM STD

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700800
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

HIP STEM SZ6 STD 132 DEG NECK

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270701915
Hospital Revenue Code	278
Min. Negotiated Rate	$65.07
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

HIP STEM SZ6 STD 132 DEG NECK

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270701915
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

HIP STRPPING

Facility

$468.75

Service Code	HCPCS 29520
Hospital Charge Code	5780155
Hospital Revenue Code	450
Min. Negotiated Rate	$12.42
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$12.42

HIP STRPPING

Facility

$468.75

Service Code	HCPCS 29520
Hospital Charge Code	5780155
Hospital Revenue Code	450
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

HIP SYS 132 DEG NECK ANGLE V40

Facility

$16,659.00

Service Code	HCPCS C1776
Hospital Charge Code	270646335
Hospital Revenue Code	278
Min. Negotiated Rate	$2,498.85
Max. Negotiated Rate	$4,031.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,331.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,031.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,664.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,498.85

HIP SYS 132 DEG NECK ANGLE V40

Facility

$16,659.00

Service Code	HCPCS C1776
Hospital Charge Code	270646335
Hospital Revenue Code	278
Min. Negotiated Rate	$401.48
Max. Negotiated Rate	$8,329.50
Rate for Payer: Aetna Commercial	$6,330.42
Rate for Payer: Aetna Medicare Advantage	$4,997.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,331.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,248.05
Rate for Payer: Cigna Commercial	$8,329.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,031.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,664.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,498.85
Rate for Payer: UnitedHealthcare Community & State	$401.48
Rate for Payer: Wellpoint Medicaid Managed Care	$441.46

HIP SYST ACCOLADE C 132D TPR

Facility

$23,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270664953
Hospital Revenue Code	278
Min. Negotiated Rate	$3,573.75
Max. Negotiated Rate	$5,765.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,765.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,241.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,573.75

HIP SYST ACCOLADE C 132D TPR

Facility

$23,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270664953
Hospital Revenue Code	278
Min. Negotiated Rate	$574.18
Max. Negotiated Rate	$11,912.50
Rate for Payer: Aetna Commercial	$9,053.50
Rate for Payer: Aetna Medicare Advantage	$7,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,075.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,075.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,075.38
Rate for Payer: Cigna Commercial	$11,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,765.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,241.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,573.75
Rate for Payer: UnitedHealthcare Community & State	$574.18
Rate for Payer: Wellpoint Medicaid Managed Care	$631.36

HIP SYSTEM 28x46MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677119
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

HIP SYSTEM 28x46MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677119
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

HIP SYSTEM AVENIR

Facility

$14,785.00

Service Code	HCPCS C1776
Hospital Charge Code	270688346
Hospital Revenue Code	278
Min. Negotiated Rate	$2,217.75
Max. Negotiated Rate	$3,577.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,577.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,252.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,217.75

Know your out-of-pocket cost for care.

All Charges