Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$623.59
Max. Negotiated Rate	$12,937.50
Rate for Payer: Aetna Commercial	$9,832.50
Rate for Payer: Aetna Medicare Advantage	$7,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,598.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,598.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,598.12
Rate for Payer: Cigna Commercial	$12,937.50
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
Rate for Payer: UnitedHealthcare Community & State	$623.59
Rate for Payer: Wellpoint Medicaid Managed Care	$685.69

HUMERAL EXTENSION +9MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672166
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

HUMERAL EXTENSION +9MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672166
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

HUMERAL FRACTURE STEM 6MMX122M

Facility

$24,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270705443
Hospital Revenue Code	278
Min. Negotiated Rate	$593.10
Max. Negotiated Rate	$12,305.00
Rate for Payer: Aetna Commercial	$9,351.80
Rate for Payer: Aetna Medicare Advantage	$7,383.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,275.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,275.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,922.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,275.55
Rate for Payer: Cigna Commercial	$12,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,955.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,414.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,691.50
Rate for Payer: UnitedHealthcare Community & State	$593.10
Rate for Payer: Wellpoint Medicaid Managed Care	$652.16

HUMERAL FRACTURE STEM 6MMX122M

Facility

$24,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270705443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,691.50
Max. Negotiated Rate	$5,955.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,955.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,414.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,691.50

HUMERAL FX ORTHOSIS - BONEL

Facility

$1,480.85

Hospital Charge Code	270614723
Hospital Revenue Code	274
Min. Negotiated Rate	$35.69
Max. Negotiated Rate	$740.42
Rate for Payer: Aetna Commercial	$562.72
Rate for Payer: Aetna Medicare Advantage	$444.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.62
Rate for Payer: Cigna Commercial	$740.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.79
Rate for Payer: Qualcare PPO/HMO/WC	$222.13
Rate for Payer: UnitedHealthcare Community & State	$35.69
Rate for Payer: Wellpoint Medicaid Managed Care	$39.24

HUMERAL FX ORTHOSIS - BONEL

Facility

$1,480.85

Hospital Charge Code	270614723
Hospital Revenue Code	274
Min. Negotiated Rate	$222.13
Max. Negotiated Rate	$358.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.79
Rate for Payer: Qualcare PPO/HMO/WC	$222.13

HUMERAL GUIDE PIN 3.5 NON

Facility

$865.00

Hospital Charge Code	270703972
Hospital Revenue Code	279
Min. Negotiated Rate	$129.75
Max. Negotiated Rate	$129.75
Rate for Payer: Qualcare PPO/HMO/WC	$129.75

HUMERAL GUIDE PIN 3.5 NON

Facility

$865.00

Hospital Charge Code	270703972
Hospital Revenue Code	279
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$432.50
Rate for Payer: Aetna Commercial	$328.70
Rate for Payer: Aetna Medicare Advantage	$259.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.57
Rate for Payer: Cigna Commercial	$432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.50
Rate for Payer: Oxford Commercial	$173.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.75
Rate for Payer: UnitedHealthcare Commercial	$173.00
Rate for Payer: UnitedHealthcare Community & State	$20.85
Rate for Payer: Wellpoint Medicaid Managed Care	$22.92

HUMERAL HD CENTR GLENO 36MM

Facility

$6,982.50

Service Code	HCPCS C1776
Hospital Charge Code	270695303
Hospital Revenue Code	278
Min. Negotiated Rate	$168.28
Max. Negotiated Rate	$3,491.25
Rate for Payer: Aetna Commercial	$2,653.35
Rate for Payer: Aetna Medicare Advantage	$2,094.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.54
Rate for Payer: Cigna Commercial	$3,491.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.38
Rate for Payer: UnitedHealthcare Community & State	$168.28
Rate for Payer: Wellpoint Medicaid Managed Care	$185.04

HUMERAL HD CENTR GLENO 36MM

Facility

$6,982.50

Service Code	HCPCS C1776
Hospital Charge Code	270695303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.38
Max. Negotiated Rate	$1,689.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,536.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.38

HUMERAL HEAD 40MM 18MM

Facility

$13,760.00

Hospital Charge Code	270660704
Hospital Revenue Code	278
Min. Negotiated Rate	$331.62
Max. Negotiated Rate	$6,880.00
Rate for Payer: Aetna Commercial	$5,228.80
Rate for Payer: Aetna Medicare Advantage	$4,128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,508.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,508.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,508.80
Rate for Payer: Cigna Commercial	$6,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,329.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,027.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,064.00
Rate for Payer: UnitedHealthcare Community & State	$331.62
Rate for Payer: Wellpoint Medicaid Managed Care	$364.64

HUMERAL HEAD 40MM 18MM

Facility

$13,760.00

Hospital Charge Code	270660704
Hospital Revenue Code	278
Min. Negotiated Rate	$2,064.00
Max. Negotiated Rate	$3,329.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,752.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,329.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,027.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,064.00

HUMERAL HEAD 40MMx21MM SOLAR

Facility

$14,750.00

Hospital Charge Code	270663621
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,245.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

HUMERAL HEAD 40MMx21MM SOLAR

Facility

$14,750.00

Hospital Charge Code	270663621
Hospital Revenue Code	278
Min. Negotiated Rate	$355.48
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$5,605.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,245.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50
Rate for Payer: UnitedHealthcare Community & State	$355.48
Rate for Payer: Wellpoint Medicaid Managed Care	$390.88

HUMERAL HEAD 40X14MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700459
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

HUMERAL HEAD 40X14MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700459
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

HUMERAL HEAD 45MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270669576
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$1,415.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,287.00
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

HUMERAL HEAD 45MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270669576
Hospital Revenue Code	278
Min. Negotiated Rate	$140.99
Max. Negotiated Rate	$2,925.00
Rate for Payer: Aetna Commercial	$2,223.00
Rate for Payer: Aetna Medicare Advantage	$1,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.75
Rate for Payer: Cigna Commercial	$2,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,287.00
Rate for Payer: Qualcare PPO/HMO/WC	$877.50
Rate for Payer: UnitedHealthcare Community & State	$140.99
Rate for Payer: Wellpoint Medicaid Managed Care	$155.03

HUMERAL HEAD 52x20MM STERILE

Facility

$8,750.00

Hospital Charge Code	270675694
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

HUMERAL HEAD 52x20MM STERILE

Facility

$8,750.00

Hospital Charge Code	270675694
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

HUMERAL HEAD DIA. 48MM

Facility

$4,800.00

Service Code	HCPCS C1776
Hospital Charge Code	270675414
Hospital Revenue Code	278
Min. Negotiated Rate	$115.68
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Community & State	$115.68
Rate for Payer: Wellpoint Medicaid Managed Care	$127.20

HUMERAL HEAD DIA. 48MM

Facility

$4,800.00

Service Code	HCPCS C1776
Hospital Charge Code	270675414
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$1,161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

HUMERAL HEAD EXPANDED 47MM

Facility

$7,725.00

Hospital Charge Code	270669868
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,699.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HUMERAL HEAD EXPANDED 47MM

Facility

$7,725.00

Hospital Charge Code	270669868
Hospital Revenue Code	278
Min. Negotiated Rate	$186.17
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,935.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,699.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75
Rate for Payer: UnitedHealthcare Community & State	$186.17
Rate for Payer: Wellpoint Medicaid Managed Care	$204.71

Know your out-of-pocket cost for care.

All Charges