Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM FEM CEMTD 15x140 78531521

Facility

$10,667.25

Hospital Charge Code	270632964
Hospital Revenue Code	278
Min. Negotiated Rate	$1,600.09
Max. Negotiated Rate	$2,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,133.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,346.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,600.09

STEM FEM CEMTD 15x140 78531521

Facility

$10,667.25

Hospital Charge Code	270632964
Hospital Revenue Code	278
Min. Negotiated Rate	$257.08
Max. Negotiated Rate	$5,333.62
Rate for Payer: Aetna Commercial	$4,053.55
Rate for Payer: Aetna Medicare Advantage	$3,200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,720.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,720.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,133.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,720.15
Rate for Payer: Cigna Commercial	$5,333.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,346.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,600.09
Rate for Payer: UnitedHealthcare Community & State	$257.08
Rate for Payer: Wellpoint Medicaid Managed Care	$282.68

STEM FEM ECHO FX STD SZ9130MM

Facility

$8,820.00

Service Code	HCPCS C1776
Hospital Charge Code	270694261
Hospital Revenue Code	278
Min. Negotiated Rate	$212.56
Max. Negotiated Rate	$4,410.00
Rate for Payer: Aetna Commercial	$3,351.60
Rate for Payer: Aetna Medicare Advantage	$2,646.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,249.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,249.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,249.10
Rate for Payer: Cigna Commercial	$4,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,134.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,940.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.00
Rate for Payer: UnitedHealthcare Community & State	$212.56
Rate for Payer: Wellpoint Medicaid Managed Care	$233.73

STEM FEM ECHO FX STD SZ9130MM

Facility

$8,820.00

Service Code	HCPCS C1776
Hospital Charge Code	270694261
Hospital Revenue Code	278
Min. Negotiated Rate	$1,323.00
Max. Negotiated Rate	$2,134.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,134.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,940.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.00

STEM FEM INTEL130x180 11166013

Facility

$36,120.00

Hospital Charge Code	270644634
Hospital Revenue Code	278
Min. Negotiated Rate	$5,418.00
Max. Negotiated Rate	$8,741.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,741.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,946.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,418.00

STEM FEM INTEL130x180 11166013

Facility

$36,120.00

Hospital Charge Code	270644634
Hospital Revenue Code	278
Min. Negotiated Rate	$870.49
Max. Negotiated Rate	$18,060.00
Rate for Payer: Aetna Commercial	$13,725.60
Rate for Payer: Aetna Medicare Advantage	$10,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,210.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,210.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,210.60
Rate for Payer: Cigna Commercial	$18,060.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,741.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,946.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,418.00
Rate for Payer: UnitedHealthcare Community & State	$870.49
Rate for Payer: Wellpoint Medicaid Managed Care	$957.18

STEM FEML VERS 13x140 78411300

Facility

$17,902.50

Hospital Charge Code	270633529
Hospital Revenue Code	278
Min. Negotiated Rate	$431.45
Max. Negotiated Rate	$8,951.25
Rate for Payer: Aetna Commercial	$6,802.95
Rate for Payer: Aetna Medicare Advantage	$5,370.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,565.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,565.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,580.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,565.14
Rate for Payer: Cigna Commercial	$8,951.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,332.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,938.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,685.38
Rate for Payer: UnitedHealthcare Community & State	$431.45
Rate for Payer: Wellpoint Medicaid Managed Care	$474.42

STEM FEML VERS 13x140 78411300

Facility

$17,902.50

Hospital Charge Code	270633529
Hospital Revenue Code	278
Min. Negotiated Rate	$2,685.38
Max. Negotiated Rate	$4,332.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,580.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,332.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,938.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,685.38

STEM FEMORA 15X160 STD 7845-15

Facility

$21,315.00

Hospital Charge Code	270638718
Hospital Revenue Code	278
Min. Negotiated Rate	$513.69
Max. Negotiated Rate	$10,657.50
Rate for Payer: Aetna Commercial	$8,099.70
Rate for Payer: Aetna Medicare Advantage	$6,394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,435.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,435.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,435.32
Rate for Payer: Cigna Commercial	$10,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,158.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,689.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,197.25
Rate for Payer: UnitedHealthcare Community & State	$513.69
Rate for Payer: Wellpoint Medicaid Managed Care	$564.85

STEM FEMORA 15X160 STD 7845-15

Facility

$21,315.00

Hospital Charge Code	270638718
Hospital Revenue Code	278
Min. Negotiated Rate	$3,197.25
Max. Negotiated Rate	$5,158.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,158.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,689.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,197.25

STEM FEMORAL 11mm 162611

Facility

$19,349.00

Hospital Charge Code	270634931
Hospital Revenue Code	278
Min. Negotiated Rate	$2,902.35
Max. Negotiated Rate	$4,682.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,869.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,682.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,256.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,902.35

STEM FEMORAL 11mm 162611

Facility

$19,349.00

Hospital Charge Code	270634931
Hospital Revenue Code	278
Min. Negotiated Rate	$466.31
Max. Negotiated Rate	$9,674.50
Rate for Payer: Aetna Commercial	$7,352.62
Rate for Payer: Aetna Medicare Advantage	$5,804.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,933.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,933.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,869.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,933.99
Rate for Payer: Cigna Commercial	$9,674.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,682.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,256.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,902.35
Rate for Payer: UnitedHealthcare Community & State	$466.31
Rate for Payer: Wellpoint Medicaid Managed Care	$512.75

STEM FEMORAL 13X145 11162715

Facility

$9,245.50

Hospital Charge Code	270634105
Hospital Revenue Code	278
Min. Negotiated Rate	$222.82
Max. Negotiated Rate	$4,622.75
Rate for Payer: Aetna Commercial	$3,513.29
Rate for Payer: Aetna Medicare Advantage	$2,773.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,357.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,357.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,849.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,357.60
Rate for Payer: Cigna Commercial	$4,622.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,237.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,034.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,386.83
Rate for Payer: UnitedHealthcare Community & State	$222.82
Rate for Payer: Wellpoint Medicaid Managed Care	$245.01

STEM FEMORAL 13X145 11162715

Facility

$9,245.50

Hospital Charge Code	270634105
Hospital Revenue Code	278
Min. Negotiated Rate	$1,386.83
Max. Negotiated Rate	$2,237.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,849.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,237.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,034.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,386.83

STEM FEMORAL 17X160MM STD

Facility

$20,300.35

Hospital Charge Code	270638745
Hospital Revenue Code	278
Min. Negotiated Rate	$489.24
Max. Negotiated Rate	$10,150.17
Rate for Payer: Aetna Commercial	$7,714.13
Rate for Payer: Aetna Medicare Advantage	$6,090.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,176.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,176.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,060.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,176.59
Rate for Payer: Cigna Commercial	$10,150.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,912.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,466.08
Rate for Payer: Qualcare PPO/HMO/WC	$3,045.05
Rate for Payer: UnitedHealthcare Community & State	$489.24
Rate for Payer: Wellpoint Medicaid Managed Care	$537.96

STEM FEMORAL 17X160MM STD

Facility

$20,300.35

Hospital Charge Code	270638745
Hospital Revenue Code	278
Min. Negotiated Rate	$3,045.05
Max. Negotiated Rate	$4,912.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,060.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,912.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,466.08
Rate for Payer: Qualcare PPO/HMO/WC	$3,045.05

STEM FEMORAL 45mm SHELL7833-11

Facility

$6,395.65

Hospital Charge Code	270628991
Hospital Revenue Code	278
Min. Negotiated Rate	$154.14
Max. Negotiated Rate	$3,197.82
Rate for Payer: Aetna Commercial	$2,430.35
Rate for Payer: Aetna Medicare Advantage	$1,918.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,630.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,630.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,630.89
Rate for Payer: Cigna Commercial	$3,197.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,407.04
Rate for Payer: Qualcare PPO/HMO/WC	$959.35
Rate for Payer: UnitedHealthcare Community & State	$154.14
Rate for Payer: Wellpoint Medicaid Managed Care	$169.48

STEM FEMORAL 45mm SHELL7833-11

Facility

$6,395.65

Hospital Charge Code	270628991
Hospital Revenue Code	278
Min. Negotiated Rate	$959.35
Max. Negotiated Rate	$1,547.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,407.04
Rate for Payer: Qualcare PPO/HMO/WC	$959.35

STEM FEMORAL CRUCIATE RT SZ4

Facility

$7,845.00

Service Code	HCPCS C1776
Hospital Charge Code	270692203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,725.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

STEM FEMORAL CRUCIATE RT SZ4

Facility

$7,845.00

Service Code	HCPCS C1776
Hospital Charge Code	270692203
Hospital Revenue Code	278
Min. Negotiated Rate	$189.06
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,725.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$189.06
Rate for Payer: Wellpoint Medicaid Managed Care	$207.89

STEM FEMORAL EXT OSS 11X150MM

Facility

$10,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270667950
Hospital Revenue Code	278
Min. Negotiated Rate	$250.40
Max. Negotiated Rate	$5,195.00
Rate for Payer: Aetna Commercial	$3,948.20
Rate for Payer: Aetna Medicare Advantage	$3,117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,649.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,649.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,078.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,649.45
Rate for Payer: Cigna Commercial	$5,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,514.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,285.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,558.50
Rate for Payer: UnitedHealthcare Community & State	$250.40
Rate for Payer: Wellpoint Medicaid Managed Care	$275.33

STEM FEMORAL EXT OSS 11X150MM

Facility

$10,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270667950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,558.50
Max. Negotiated Rate	$2,514.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,078.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,514.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,285.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,558.50

STEM FEMORAL EXT TIB 10x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677686
Hospital Revenue Code	278
Min. Negotiated Rate	$100.37
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,582.61
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$916.25
Rate for Payer: Qualcare PPO/HMO/WC	$624.71
Rate for Payer: UnitedHealthcare Community & State	$100.37
Rate for Payer: Wellpoint Medicaid Managed Care	$110.37

STEM FEMORAL EXT TIB 10x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677686
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$916.25
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 14X25MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678639
Hospital Revenue Code	278
Min. Negotiated Rate	$100.37
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,582.61
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$916.25
Rate for Payer: Qualcare PPO/HMO/WC	$624.71
Rate for Payer: UnitedHealthcare Community & State	$100.37
Rate for Payer: Wellpoint Medicaid Managed Care	$110.37

Know your out-of-pocket cost for care.

All Charges