Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HUMERAL ADAPTER TRAY +10MM

Facility

$8,392.35

Service Code	HCPCS C1776
Hospital Charge Code	270673291
Hospital Revenue Code	278
Min. Negotiated Rate	$1,258.85
Max. Negotiated Rate	$2,030.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,678.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,030.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,846.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,258.85

HUMERAL ADAPTER TRAY +10MM

Facility

$8,392.35

Service Code	HCPCS C1776
Hospital Charge Code	270673291
Hospital Revenue Code	278
Min. Negotiated Rate	$202.26
Max. Negotiated Rate	$4,196.18
Rate for Payer: Aetna Commercial	$3,189.09
Rate for Payer: Aetna Medicare Advantage	$2,517.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,140.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,140.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,678.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,140.05
Rate for Payer: Cigna Commercial	$4,196.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,030.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,846.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,258.85
Rate for Payer: UnitedHealthcare Community & State	$202.26
Rate for Payer: Wellpoint Medicaid Managed Care	$222.40

HUMERAL BEARING

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668580
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$84.35
Rate for Payer: Wellpoint Medicaid Managed Care	$92.75

HUMERAL BEARING

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668580
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

HUMERAL BEARING 44X36MM

Facility

$7,945.00

Hospital Charge Code	270670924
Hospital Revenue Code	278
Min. Negotiated Rate	$1,191.75
Max. Negotiated Rate	$1,922.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,589.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,922.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,747.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.75

HUMERAL BEARING 44X36MM

Facility

$7,945.00

Hospital Charge Code	270670924
Hospital Revenue Code	278
Min. Negotiated Rate	$191.47
Max. Negotiated Rate	$3,972.50
Rate for Payer: Aetna Commercial	$3,019.10
Rate for Payer: Aetna Medicare Advantage	$2,383.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,025.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,025.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,589.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,025.97
Rate for Payer: Cigna Commercial	$3,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,922.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,747.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.75
Rate for Payer: UnitedHealthcare Community & State	$191.47
Rate for Payer: Wellpoint Medicaid Managed Care	$210.54

HUMERAL BODY FINNED REVERSE

Facility

$9,955.00

Service Code	HCPCS C1776
Hospital Charge Code	270672167
Hospital Revenue Code	278
Min. Negotiated Rate	$1,493.25
Max. Negotiated Rate	$2,409.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,991.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,409.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,190.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,493.25

HUMERAL BODY FINNED REVERSE

Facility

$9,955.00

Service Code	HCPCS C1776
Hospital Charge Code	270672167
Hospital Revenue Code	278
Min. Negotiated Rate	$239.92
Max. Negotiated Rate	$4,977.50
Rate for Payer: Aetna Commercial	$3,782.90
Rate for Payer: Aetna Medicare Advantage	$2,986.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,538.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,538.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,991.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,538.53
Rate for Payer: Cigna Commercial	$4,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,409.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,190.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,493.25
Rate for Payer: UnitedHealthcare Community & State	$239.92
Rate for Payer: Wellpoint Medicaid Managed Care	$263.81

HUMERAL BODY FINNED REV SHORT

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270680552
Hospital Revenue Code	278
Min. Negotiated Rate	$414.76
Max. Negotiated Rate	$8,605.00
Rate for Payer: Aetna Commercial	$6,539.80
Rate for Payer: Aetna Medicare Advantage	$5,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,388.55
Rate for Payer: Cigna Commercial	$8,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,786.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50
Rate for Payer: UnitedHealthcare Community & State	$414.76
Rate for Payer: Wellpoint Medicaid Managed Care	$456.06

HUMERAL BODY FINNED REV SHORT

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270680552
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$4,164.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,786.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY FINNED W/SCREW

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270672313
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$3,550.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,227.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODY FINNED W/SCREW

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270672313
Hospital Revenue Code	278
Min. Negotiated Rate	$353.55
Max. Negotiated Rate	$7,335.00
Rate for Payer: Aetna Commercial	$5,574.60
Rate for Payer: Aetna Medicare Advantage	$4,401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,740.85
Rate for Payer: Cigna Commercial	$7,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,227.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50
Rate for Payer: UnitedHealthcare Community & State	$353.55
Rate for Payer: Wellpoint Medicaid Managed Care	$388.75

HUMERAL BODYLONG

Facility

$20,000.00

Hospital Charge Code	270669577
Hospital Revenue Code	278
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$482.00
Rate for Payer: Wellpoint Medicaid Managed Care	$530.00

HUMERAL BODYLONG

Facility

$20,000.00

Hospital Charge Code	270669577
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

HUMERAL BODY SMR SHOULDER HUME

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270678402
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$4,164.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,786.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY SMR SHOULDER HUME

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270678402
Hospital Revenue Code	278
Min. Negotiated Rate	$414.76
Max. Negotiated Rate	$8,605.00
Rate for Payer: Aetna Commercial	$6,539.80
Rate for Payer: Aetna Medicare Advantage	$5,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,388.55
Rate for Payer: Cigna Commercial	$8,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,786.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50
Rate for Payer: UnitedHealthcare Community & State	$414.76
Rate for Payer: Wellpoint Medicaid Managed Care	$456.06

HUMERAL BODY TRAUMA MEDIUM

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270666201
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$3,550.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,227.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODY TRAUMA MEDIUM

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270666201
Hospital Revenue Code	278
Min. Negotiated Rate	$353.55
Max. Negotiated Rate	$7,335.00
Rate for Payer: Aetna Commercial	$5,574.60
Rate for Payer: Aetna Medicare Advantage	$4,401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,740.85
Rate for Payer: Cigna Commercial	$7,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,227.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50
Rate for Payer: UnitedHealthcare Community & State	$353.55
Rate for Payer: Wellpoint Medicaid Managed Care	$388.75

HUMERAL BODY TRAUMA SHORT

Facility

$20,000.00

Hospital Charge Code	270666204
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

HUMERAL BODY TRAUMA SHORT

Facility

$20,000.00

Hospital Charge Code	270666204
Hospital Revenue Code	278
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$482.00
Rate for Payer: Wellpoint Medicaid Managed Care	$530.00

HUMERAL BODY TRAY STD 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693795
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

HUMERAL BODY TRAY STD 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693795
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

HUMERAL CUP RVRS SZ 3/4 36MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700531
Hospital Revenue Code	278
Min. Negotiated Rate	$3,105.00
Max. Negotiated Rate	$5,009.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,009.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,554.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,105.00

HUMERAL CUP RVRS SZ 3/4 36MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700531
Hospital Revenue Code	278
Min. Negotiated Rate	$498.87
Max. Negotiated Rate	$10,350.00
Rate for Payer: Aetna Commercial	$7,866.00
Rate for Payer: Aetna Medicare Advantage	$6,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,278.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,278.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,278.50
Rate for Payer: Cigna Commercial	$10,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,009.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,554.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,105.00
Rate for Payer: UnitedHealthcare Community & State	$498.87
Rate for Payer: Wellpoint Medicaid Managed Care	$548.55

HUMERAL CUP RVRS SZ3/4 6X42MM

Facility

$25,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270700524
Hospital Revenue Code	278
Min. Negotiated Rate	$3,881.25
Max. Negotiated Rate	$6,261.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,261.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,692.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,881.25

Know your out-of-pocket cost for care.

All Charges