Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM FEMORAL EXT TIB 14X25MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678639
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 16x120MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678640
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 16x120MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678640
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 16x80MM

Facility

$4,164.50

Service Code	HCPCS C1776
Hospital Charge Code	270676557
Hospital Revenue Code	278
Min. Negotiated Rate	$100.36
Max. Negotiated Rate	$2,082.25
Rate for Payer: Aetna Commercial	$1,582.51
Rate for Payer: Aetna Medicare Advantage	$1,249.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,061.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,061.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,061.95
Rate for Payer: Cigna Commercial	$2,082.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$916.19
Rate for Payer: Qualcare PPO/HMO/WC	$624.67
Rate for Payer: UnitedHealthcare Community & State	$100.36
Rate for Payer: Wellpoint Medicaid Managed Care	$110.36

STEM FEMORAL EXT TIB 16x80MM

Facility

$4,164.50

Service Code	HCPCS C1776
Hospital Charge Code	270676557
Hospital Revenue Code	278
Min. Negotiated Rate	$624.67
Max. Negotiated Rate	$1,007.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$916.19
Rate for Payer: Qualcare PPO/HMO/WC	$624.67

STEM FEMORAL EXT TIB 20x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676683
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 20x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676683
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 FIBR.METL TAPER

Facility

$15,948.55

Hospital Charge Code	270657119
Hospital Revenue Code	278
Min. Negotiated Rate	$2,392.28
Max. Negotiated Rate	$3,859.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,189.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,859.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,508.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,392.28

STEM - FEMORAL FIBR.METL TAPER

Facility

$15,948.55

Hospital Charge Code	270657119
Hospital Revenue Code	278
Min. Negotiated Rate	$384.36
Max. Negotiated Rate	$7,974.27
Rate for Payer: Aetna Commercial	$6,060.45
Rate for Payer: Aetna Medicare Advantage	$4,784.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,066.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,066.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,189.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,066.88
Rate for Payer: Cigna Commercial	$7,974.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,859.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,508.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,392.28
Rate for Payer: UnitedHealthcare Community & State	$384.36
Rate for Payer: Wellpoint Medicaid Managed Care	$422.64

STEM FEMORAL FX HIP 11X140MM

Facility

$6,275.00

Service Code	HCPCS C1776
Hospital Charge Code	270640212
Hospital Revenue Code	278
Min. Negotiated Rate	$151.23
Max. Negotiated Rate	$3,137.50
Rate for Payer: Aetna Commercial	$2,384.50
Rate for Payer: Aetna Medicare Advantage	$1,882.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.12
Rate for Payer: Cigna Commercial	$3,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,518.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,380.50
Rate for Payer: Qualcare PPO/HMO/WC	$941.25
Rate for Payer: UnitedHealthcare Community & State	$151.23
Rate for Payer: Wellpoint Medicaid Managed Care	$166.29

STEM FEMORAL FX HIP 11X140MM

Facility

$6,275.00

Service Code	HCPCS C1776
Hospital Charge Code	270640212
Hospital Revenue Code	278
Min. Negotiated Rate	$941.25
Max. Negotiated Rate	$1,518.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,518.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,380.50
Rate for Payer: Qualcare PPO/HMO/WC	$941.25

STEM FEMORAL INTEGRL 12X180mm

Facility

$41,815.00

Hospital Charge Code	270665224
Hospital Revenue Code	278
Min. Negotiated Rate	$1,007.74
Max. Negotiated Rate	$20,907.50
Rate for Payer: Aetna Commercial	$15,889.70
Rate for Payer: Aetna Medicare Advantage	$12,544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,662.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,662.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,662.83
Rate for Payer: Cigna Commercial	$20,907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,119.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,199.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,272.25
Rate for Payer: UnitedHealthcare Community & State	$1,007.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,108.10

STEM FEMORAL INTEGRL 12X180mm

Facility

$41,815.00

Hospital Charge Code	270665224
Hospital Revenue Code	278
Min. Negotiated Rate	$6,272.25
Max. Negotiated Rate	$10,119.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,363.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,119.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,199.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,272.25

STEM FEMORAL INTEGRL 160x180MM

Facility

$40,205.00

Hospital Charge Code	270651664
Hospital Revenue Code	278
Min. Negotiated Rate	$6,030.75
Max. Negotiated Rate	$9,729.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,041.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,729.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,845.10
Rate for Payer: Qualcare PPO/HMO/WC	$6,030.75

STEM FEMORAL INTEGRL 160x180MM

Facility

$40,205.00

Hospital Charge Code	270651664
Hospital Revenue Code	278
Min. Negotiated Rate	$968.94
Max. Negotiated Rate	$20,102.50
Rate for Payer: Aetna Commercial	$15,277.90
Rate for Payer: Aetna Medicare Advantage	$12,061.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,252.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,252.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,041.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,252.27
Rate for Payer: Cigna Commercial	$20,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,729.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,845.10
Rate for Payer: Qualcare PPO/HMO/WC	$6,030.75
Rate for Payer: UnitedHealthcare Community & State	$968.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1,065.43

STEM FEMORAL LAT AVENIR SZ5

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698185
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 FEMORAL LAT AVENIR SZ5

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698185
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 FEMORAL LG 140MM *****

Facility

$4,740.00

Hospital Charge Code	270606988
Hospital Revenue Code	279
Min. Negotiated Rate	$114.23
Max. Negotiated Rate	$2,370.00
Rate for Payer: Aetna Commercial	$1,801.20
Rate for Payer: Aetna Medicare Advantage	$1,422.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,208.70
Rate for Payer: Cigna Commercial	$2,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,422.00
Rate for Payer: Oxford Commercial	$948.00
Rate for Payer: Qualcare PPO/HMO/WC	$711.00
Rate for Payer: UnitedHealthcare Commercial	$948.00
Rate for Payer: UnitedHealthcare Community & State	$114.23
Rate for Payer: Wellpoint Medicaid Managed Care	$125.61

STEM FEMORAL LG 140MM *****

Facility

$4,740.00

Hospital Charge Code	270606988
Hospital Revenue Code	279
Min. Negotiated Rate	$711.00
Max. Negotiated Rate	$711.00
Rate for Payer: Qualcare PPO/HMO/WC	$711.00

STEM FEMORAL NECK SHORT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270676061
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STEM FEMORAL NECK SHORT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270676061
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

STEM FEMORAL PF TAP SZ10 10MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692925
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 FEMORAL PF TAP SZ10 10MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692925
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 FEMORAL PS OPEN 60mm RT

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270644717
Hospital Revenue Code	278
Min. Negotiated Rate	$415.24
Max. Negotiated Rate	$8,615.00
Rate for Payer: Aetna Commercial	$6,547.40
Rate for Payer: Aetna Medicare Advantage	$5,169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,393.65
Rate for Payer: Cigna Commercial	$8,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,790.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50
Rate for Payer: UnitedHealthcare Community & State	$415.24
Rate for Payer: Wellpoint Medicaid Managed Care	$456.60

STEM FEMORAL PS OPEN 60mm RT

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270644717
Hospital Revenue Code	278
Min. Negotiated Rate	$2,584.50
Max. Negotiated Rate	$4,169.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,790.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50

Know your out-of-pocket cost for care.

All Charges