Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM EXTENSION SCREW REPLAC

Facility

$823.33

Hospital Charge Code	270657078
Hospital Revenue Code	278
Min. Negotiated Rate	$123.50
Max. Negotiated Rate	$199.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.13
Rate for Payer: Qualcare PPO/HMO/WC	$123.50

STEM EXT FEMORAL TIB 14X80MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668747
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

STEM EXT FEMORAL TIB 14X80MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668747
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

STEM EXT FEM &TIB CEM 10x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680667
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$2,664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,422.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXT FEM &TIB CEM 10x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680667
Hospital Revenue Code	278
Min. Negotiated Rate	$265.34
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$4,183.80
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,422.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50
Rate for Payer: UnitedHealthcare Community & State	$265.34
Rate for Payer: Wellpoint Medicaid Managed Care	$291.76

STEM EXT FEM &TIB CEM 12x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680666
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$2,664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,422.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXT FEM &TIB CEM 12x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680666
Hospital Revenue Code	278
Min. Negotiated Rate	$265.34
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$4,183.80
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,422.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50
Rate for Payer: UnitedHealthcare Community & State	$265.34
Rate for Payer: Wellpoint Medicaid Managed Care	$291.76

STEM EXT TAPERED SMTH PSN 14X7

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270690151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$4,386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

STEM EXT TAPERED SMTH PSN 14X7

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270690151
Hospital Revenue Code	278
Min. Negotiated Rate	$436.81
Max. Negotiated Rate	$9,062.50
Rate for Payer: Aetna Commercial	$6,887.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,621.88
Rate for Payer: Cigna Commercial	$9,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Community & State	$436.81
Rate for Payer: Wellpoint Medicaid Managed Care	$480.31

STEM FEM 12/14 TAPER SZ6 127MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270699296
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

STEM FEM 12/14 TAPER SZ6 127MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270699296
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

STEM FEM 12/14 TAP SZ 5 120MM

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	270697315
Hospital Revenue Code	278
Min. Negotiated Rate	$1,456.50
Max. Negotiated Rate	$2,349.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,942.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,349.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,136.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,456.50

STEM FEM 12/14 TAP SZ 5 120MM

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	270697315
Hospital Revenue Code	278
Min. Negotiated Rate	$234.01
Max. Negotiated Rate	$4,855.00
Rate for Payer: Aetna Commercial	$3,689.80
Rate for Payer: Aetna Medicare Advantage	$2,913.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,476.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,476.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,942.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,476.05
Rate for Payer: Cigna Commercial	$4,855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,349.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,136.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,456.50
Rate for Payer: UnitedHealthcare Community & State	$234.01
Rate for Payer: Wellpoint Medicaid Managed Care	$257.31

STEM FEM 13X14 STDBODY 784113

Facility

$19,519.40

Hospital Charge Code	270629822
Hospital Revenue Code	278
Min. Negotiated Rate	$470.42
Max. Negotiated Rate	$9,759.70
Rate for Payer: Aetna Commercial	$7,417.37
Rate for Payer: Aetna Medicare Advantage	$5,855.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,977.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,977.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,903.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,977.45
Rate for Payer: Cigna Commercial	$9,759.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,723.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,294.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,927.91
Rate for Payer: UnitedHealthcare Community & State	$470.42
Rate for Payer: Wellpoint Medicaid Managed Care	$517.26

STEM FEM 13X14 STDBODY 784113

Facility

$19,519.40

Hospital Charge Code	270629822
Hospital Revenue Code	278
Min. Negotiated Rate	$2,927.91
Max. Negotiated Rate	$4,723.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,903.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,723.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,294.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,927.91

STEM FEM 14x140 78411420

Facility

$20,300.20

Hospital Charge Code	270633725
Hospital Revenue Code	278
Min. Negotiated Rate	$3,045.03
Max. Negotiated Rate	$4,912.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,060.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,912.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,466.04
Rate for Payer: Qualcare PPO/HMO/WC	$3,045.03

STEM FEM 14x140 78411420

Facility

$20,300.20

Hospital Charge Code	270633725
Hospital Revenue Code	278
Min. Negotiated Rate	$489.23
Max. Negotiated Rate	$10,150.10
Rate for Payer: Aetna Commercial	$7,714.08
Rate for Payer: Aetna Medicare Advantage	$6,090.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,176.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,176.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,060.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,176.55
Rate for Payer: Cigna Commercial	$10,150.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,912.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,466.04
Rate for Payer: Qualcare PPO/HMO/WC	$3,045.03
Rate for Payer: UnitedHealthcare Community & State	$489.23
Rate for Payer: Wellpoint Medicaid Managed Care	$537.96

STEM FEM ARCOS 13X210MM 0 CALC

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270698954
Hospital Revenue Code	278
Min. Negotiated Rate	$957.25
Max. Negotiated Rate	$19,860.00
Rate for Payer: Aetna Commercial	$15,093.60
Rate for Payer: Aetna Medicare Advantage	$11,916.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,128.60
Rate for Payer: Cigna Commercial	$19,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,738.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00
Rate for Payer: UnitedHealthcare Community & State	$957.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,052.58

STEM FEM ARCOS 13X210MM 0 CALC

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270698954
Hospital Revenue Code	278
Min. Negotiated Rate	$5,958.00
Max. Negotiated Rate	$9,612.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,738.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00

STEM FEM AVEN COMP STD COL SZ2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695309
Hospital Revenue Code	278
Min. Negotiated Rate	$356.38
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$5,619.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13
Rate for Payer: UnitedHealthcare Community & State	$356.38
Rate for Payer: Wellpoint Medicaid Managed Care	$391.87

STEM FEM AVEN COMP STD COL SZ2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695309
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

STEM FEM BROACH STD 15X175MM

Facility

$10,815.00

Service Code	HCPCS C1776
Hospital Charge Code	270699266
Hospital Revenue Code	278
Min. Negotiated Rate	$260.64
Max. Negotiated Rate	$5,407.50
Rate for Payer: Aetna Commercial	$4,109.70
Rate for Payer: Aetna Medicare Advantage	$3,244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,757.82
Rate for Payer: Cigna Commercial	$5,407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,379.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25
Rate for Payer: UnitedHealthcare Community & State	$260.64
Rate for Payer: Wellpoint Medicaid Managed Care	$286.60

STEM FEM BROACH STD 15X175MM

Facility

$10,815.00

Service Code	HCPCS C1776
Hospital Charge Code	270699266
Hospital Revenue Code	278
Min. Negotiated Rate	$1,622.25
Max. Negotiated Rate	$2,617.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,379.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25

STEM FEM CEMET 14x135 78531421

Facility

$11,316.75

Hospital Charge Code	270634661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,697.51
Max. Negotiated Rate	$2,738.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,263.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,489.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.51

STEM FEM CEMET 14x135 78531421

Facility

$11,316.75

Hospital Charge Code	270634661
Hospital Revenue Code	278
Min. Negotiated Rate	$272.73
Max. Negotiated Rate	$5,658.38
Rate for Payer: Aetna Commercial	$4,300.36
Rate for Payer: Aetna Medicare Advantage	$3,395.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,885.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,885.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,263.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,885.77
Rate for Payer: Cigna Commercial	$5,658.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,489.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.51
Rate for Payer: UnitedHealthcare Community & State	$272.73
Rate for Payer: Wellpoint Medicaid Managed Care	$299.89

Know your out-of-pocket cost for care.

All Charges