Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

POST ATTUNE FEMORAL SZ 5 CEMEN

Facility

$10,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270687424
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

POST ATTUNE FEMORAL SZ 6 CEMNT

Facility

$10,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270687050
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

POST ATTUNE FEMORAL SZ 6 CEMNT

Facility

$10,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270687050
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

POST ATTUNE FEMORAL SZ 7 CEMEN

Facility

$10,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270687592
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

POST ATTUNE FEMORAL SZ 7 CEMEN

Facility

$10,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270687592
Hospital Revenue Code	278
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

POST AUG SZ 95MM REV PSN

Facility

$7,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270690148
Hospital Revenue Code	278
Min. Negotiated Rate	$192.20
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$3,030.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25
Rate for Payer: UnitedHealthcare Community & State	$192.20
Rate for Payer: Wellpoint Medicaid Managed Care	$211.34

POST AUG SZ 95MM REV PSN

Facility

$7,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270690148
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

POST CAPSULAR RELEASE KNEE

Facility

$10,493.36

Service Code	HCPCS 27435
Hospital Charge Code	1600000464
Hospital Revenue Code	360
Min. Negotiated Rate	$252.89
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,148.01
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,574.00
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$252.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$278.07

POST CAPSULAR RELEASE KNEE

Facility

$10,493.36

Service Code	HCPCS 27435
Hospital Charge Code	1600000464
Hospital Revenue Code	360
Min. Negotiated Rate	$1,574.00
Max. Negotiated Rate	$1,574.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,574.00

POST CHAMBER LENS MC60CM ALCON

Facility

$174.00

Hospital Charge Code	270335902
Hospital Revenue Code	276
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Community & State	$4.19
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

POST CHAMBER LENS MC60CM ALCON

Facility

$174.00

Hospital Charge Code	270335902
Hospital Revenue Code	276
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$42.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

POST CHAMBER LENS SA60AT-ALCON

Facility

$306.00

Hospital Charge Code	270335901
Hospital Revenue Code	276
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$74.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.32
Rate for Payer: Qualcare PPO/HMO/WC	$45.90

POST CHAMBER LENS SA60AT-ALCON

Facility

$306.00

Hospital Charge Code	270335901
Hospital Revenue Code	276
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$153.00
Rate for Payer: Aetna Commercial	$116.28
Rate for Payer: Aetna Medicare Advantage	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.03
Rate for Payer: Cigna Commercial	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.32
Rate for Payer: Qualcare PPO/HMO/WC	$45.90
Rate for Payer: UnitedHealthcare Community & State	$7.37
Rate for Payer: Wellpoint Medicaid Managed Care	$8.11

POST CHAMBER LENS-SN60WF ALCON

Facility

$347.00

Hospital Charge Code	270335900
Hospital Revenue Code	276
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$173.50
Rate for Payer: Aetna Commercial	$131.86
Rate for Payer: Aetna Medicare Advantage	$104.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.48
Rate for Payer: Cigna Commercial	$173.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.34
Rate for Payer: Qualcare PPO/HMO/WC	$52.05
Rate for Payer: UnitedHealthcare Community & State	$8.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

POST CHAMBER LENS-SN60WF ALCON

Facility

$347.00

Hospital Charge Code	270335900
Hospital Revenue Code	276
Min. Negotiated Rate	$52.05
Max. Negotiated Rate	$83.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.34
Rate for Payer: Qualcare PPO/HMO/WC	$52.05

POST-ENDO RECOVERY/HR

Facility

$800.00

Hospital Charge Code	1500112
Hospital Revenue Code	710
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

POST-ENDO RECOVERY/HR

Facility

$800.00

Hospital Charge Code	1500112
Hospital Revenue Code	710
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

POSTERIOR LATERAL PLATE

Facility

$2,321.25

Hospital Charge Code	270657771
Hospital Revenue Code	278
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$1,160.62
Rate for Payer: Aetna Commercial	$882.08
Rate for Payer: Aetna Medicare Advantage	$696.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$591.92
Rate for Payer: Cigna Commercial	$1,160.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$510.68
Rate for Payer: Qualcare PPO/HMO/WC	$348.19
Rate for Payer: UnitedHealthcare Community & State	$55.94
Rate for Payer: Wellpoint Medicaid Managed Care	$61.51

POSTERIOR LATERAL PLATE

Facility

$2,321.25

Hospital Charge Code	270657771
Hospital Revenue Code	278
Min. Negotiated Rate	$348.19
Max. Negotiated Rate	$561.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$510.68
Rate for Payer: Qualcare PPO/HMO/WC	$348.19

POSTERIOR LATERAL RISHT PLATE

Facility

$2,321.25

Hospital Charge Code	270657747
Hospital Revenue Code	278
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$1,160.62
Rate for Payer: Aetna Commercial	$882.08
Rate for Payer: Aetna Medicare Advantage	$696.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$591.92
Rate for Payer: Cigna Commercial	$1,160.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$510.68
Rate for Payer: Qualcare PPO/HMO/WC	$348.19
Rate for Payer: UnitedHealthcare Community & State	$55.94
Rate for Payer: Wellpoint Medicaid Managed Care	$61.51

POSTERIOR LATERAL RISHT PLATE

Facility

$2,321.25

Hospital Charge Code	270657747
Hospital Revenue Code	278
Min. Negotiated Rate	$348.19
Max. Negotiated Rate	$561.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$510.68
Rate for Payer: Qualcare PPO/HMO/WC	$348.19

POSTERIOR TBI FIXED SZ3 8MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270700498
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

POSTERIOR TBI FIXED SZ3 8MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270700498
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

POST EX-FIX LG 30DEG OUTR 11MM

Facility

$582.40

Hospital Charge Code	270642898
Hospital Revenue Code	272
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$87.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.36

POST EX-FIX LG 30DEG OUTR 11MM

Facility

$582.40

Hospital Charge Code	270642898
Hospital Revenue Code	272
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$291.20
Rate for Payer: Aetna Commercial	$221.31
Rate for Payer: Aetna Medicare Advantage	$174.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.51
Rate for Payer: Cigna Commercial	$291.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.72
Rate for Payer: Oxford Commercial	$116.48
Rate for Payer: Qualcare PPO/HMO/WC	$87.36
Rate for Payer: UnitedHealthcare Commercial	$116.48
Rate for Payer: UnitedHealthcare Community & State	$14.04
Rate for Payer: Wellpoint Medicaid Managed Care	$15.43

Know your out-of-pocket cost for care.

All Charges