Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM CTRL INTEGRL 9mm 12162609

Facility

$10,255.00

Hospital Charge Code	270625863
Hospital Revenue Code	278
Min. Negotiated Rate	$1,538.25
Max. Negotiated Rate	$2,481.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,051.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,481.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,256.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,538.25

STEM DEF FEMORAL SZ 4 STD 114

Facility

$9,025.00

Service Code	HCPCS C1776
Hospital Charge Code	270691720
Hospital Revenue Code	278
Min. Negotiated Rate	$1,353.75
Max. Negotiated Rate	$2,184.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,985.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75

STEM DEF FEMORAL SZ 4 STD 114

Facility

$9,025.00

Service Code	HCPCS C1776
Hospital Charge Code	270691720
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$4,512.50
Rate for Payer: Aetna Commercial	$3,429.50
Rate for Payer: Aetna Medicare Advantage	$2,707.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,301.38
Rate for Payer: Cigna Commercial	$4,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,985.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75
Rate for Payer: UnitedHealthcare Community & State	$217.50
Rate for Payer: Wellpoint Medicaid Managed Care	$239.16

STEM DISL 15 MALRY MD 11108255

Facility

$9,825.85

Hospital Charge Code	270633598
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.88
Max. Negotiated Rate	$2,377.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.88

STEM DISL 15 MALRY MD 11108255

Facility

$9,825.85

Hospital Charge Code	270633598
Hospital Revenue Code	278
Min. Negotiated Rate	$236.80
Max. Negotiated Rate	$4,912.93
Rate for Payer: Aetna Commercial	$3,733.82
Rate for Payer: Aetna Medicare Advantage	$2,947.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.59
Rate for Payer: Cigna Commercial	$4,912.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.88
Rate for Payer: UnitedHealthcare Community & State	$236.80
Rate for Payer: Wellpoint Medicaid Managed Care	$260.39

STEM DISTAL BULLET BOWED

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270690937
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,105.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

STEM DISTAL BULLET BOWED

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270690937
Hospital Revenue Code	278
Min. Negotiated Rate	$449.71
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,105.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$449.71
Rate for Payer: Wellpoint Medicaid Managed Care	$494.49

STEM DISTAL TAPERLOC 14x148MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675678
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM DISTAL TAPERLOC 14x148MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675678
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

STEM DISTAL TAPERLOC 15X150MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270676517
Hospital Revenue Code	278
Min. Negotiated Rate	$295.23
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$4,655.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,695.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50
Rate for Payer: UnitedHealthcare Community & State	$295.23
Rate for Payer: Wellpoint Medicaid Managed Care	$324.62

STEM DISTAL TAPERLOC 15X150MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270676517
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,695.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM DISTAL TAPERLOC 4X128MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698811
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

STEM DISTAL TAPERLOC 4X128MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698811
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM DISTAL W/SCREW 16x190mm

Facility

$20,320.00

Hospital Charge Code	270675923
Hospital Revenue Code	278
Min. Negotiated Rate	$3,048.00
Max. Negotiated Rate	$4,917.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,064.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,917.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,470.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,048.00

STEM DISTAL W/SCREW 16x190mm

Facility

$20,320.00

Hospital Charge Code	270675923
Hospital Revenue Code	278
Min. Negotiated Rate	$489.71
Max. Negotiated Rate	$10,160.00
Rate for Payer: Aetna Commercial	$7,721.60
Rate for Payer: Aetna Medicare Advantage	$6,096.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,181.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,181.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,064.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,181.60
Rate for Payer: Cigna Commercial	$10,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,917.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,470.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,048.00
Rate for Payer: UnitedHealthcare Community & State	$489.71
Rate for Payer: Wellpoint Medicaid Managed Care	$538.48

STEM E1 VNGD PS+TIB BRG

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681468
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

STEM E1 VNGD PS+TIB BRG

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681468
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

STEM ECHO B-MTRC MP FP

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691088
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$7,456.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

STEM ECHO B-MTRC MP FP

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691088
Hospital Revenue Code	278
Min. Negotiated Rate	$742.52
Max. Negotiated Rate	$15,405.00
Rate for Payer: Aetna Commercial	$11,707.80
Rate for Payer: Aetna Medicare Advantage	$9,243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,856.55
Rate for Payer: Cigna Commercial	$15,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50
Rate for Payer: UnitedHealthcare Community & State	$742.52
Rate for Payer: Wellpoint Medicaid Managed Care	$816.47

STEM ECHO MTRC 7 X 94

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691943
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$7,456.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

STEM ECHO MTRC 7 X 94

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691943
Hospital Revenue Code	278
Min. Negotiated Rate	$742.52
Max. Negotiated Rate	$15,405.00
Rate for Payer: Aetna Commercial	$11,707.80
Rate for Payer: Aetna Medicare Advantage	$9,243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,856.55
Rate for Payer: Cigna Commercial	$15,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50
Rate for Payer: UnitedHealthcare Community & State	$742.52
Rate for Payer: Wellpoint Medicaid Managed Care	$816.47

STEM ECHO POR FMRL RPP SZ 9

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690981
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM ECHO POR FMRL RPP SZ 9

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690981
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

STEM ELEOS EXT CEMENTED 14 MM

Facility

$5,490.00

Service Code	HCPCS C1776
Hospital Charge Code	270682840
Hospital Revenue Code	278
Min. Negotiated Rate	$132.31
Max. Negotiated Rate	$2,745.00
Rate for Payer: Aetna Commercial	$2,086.20
Rate for Payer: Aetna Medicare Advantage	$1,647.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,399.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,399.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,098.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,399.95
Rate for Payer: Cigna Commercial	$2,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,207.80
Rate for Payer: Qualcare PPO/HMO/WC	$823.50
Rate for Payer: UnitedHealthcare Community & State	$132.31
Rate for Payer: Wellpoint Medicaid Managed Care	$145.49

STEM ELEOS EXT CEMENTED 14 MM

Facility

$5,490.00

Service Code	HCPCS C1776
Hospital Charge Code	270682840
Hospital Revenue Code	278
Min. Negotiated Rate	$823.50
Max. Negotiated Rate	$1,328.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,098.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,207.80
Rate for Payer: Qualcare PPO/HMO/WC	$823.50

Know your out-of-pocket cost for care.

All Charges