Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM FEMRL STD CLLR SZ17 150MM

Facility

$10,646.60

Hospital Charge Code	270657124
Hospital Revenue Code	278
Min. Negotiated Rate	$1,596.99
Max. Negotiated Rate	$2,576.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,129.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,576.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,596.99

STEM FEMRL STD CLLR SZ17 150MM

Facility

$10,646.60

Hospital Charge Code	270657124
Hospital Revenue Code	278
Min. Negotiated Rate	$256.58
Max. Negotiated Rate	$5,323.30
Rate for Payer: Aetna Commercial	$4,045.71
Rate for Payer: Aetna Medicare Advantage	$3,193.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,714.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,714.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,129.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,714.88
Rate for Payer: Cigna Commercial	$5,323.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,576.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,596.99
Rate for Payer: UnitedHealthcare Community & State	$256.58
Rate for Payer: Wellpoint Medicaid Managed Care	$282.13

STEM FEMRL TPR 15x140 7862-015

Facility

$16,376.00

Hospital Charge Code	270631442
Hospital Revenue Code	278
Min. Negotiated Rate	$394.66
Max. Negotiated Rate	$8,188.00
Rate for Payer: Aetna Commercial	$6,222.88
Rate for Payer: Aetna Medicare Advantage	$4,912.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,175.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,175.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,175.88
Rate for Payer: Cigna Commercial	$8,188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,602.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.40
Rate for Payer: UnitedHealthcare Community & State	$394.66
Rate for Payer: Wellpoint Medicaid Managed Care	$433.96

STEM FEMRL TPR 15x140 7862-015

Facility

$16,376.00

Hospital Charge Code	270631442
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.40
Max. Negotiated Rate	$3,962.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,602.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.40

STEMFEMSTDARCOS1PC15X210MMCALC

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270697341
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

STEMFEMSTDARCOS1PC15X210MMCALC

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270697341
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 TAP 12/14 SZ3 108MM

Facility

$9,712.50

Service Code	HCPCS C1776
Hospital Charge Code	270698953
Hospital Revenue Code	278
Min. Negotiated Rate	$1,456.88
Max. Negotiated Rate	$2,350.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,942.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,350.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,136.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,456.88

STEM FEM TAP 12/14 SZ3 108MM

Facility

$9,712.50

Service Code	HCPCS C1776
Hospital Charge Code	270698953
Hospital Revenue Code	278
Min. Negotiated Rate	$234.07
Max. Negotiated Rate	$4,856.25
Rate for Payer: Aetna Commercial	$3,690.75
Rate for Payer: Aetna Medicare Advantage	$2,913.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,476.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,476.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,476.69
Rate for Payer: Cigna Commercial	$4,856.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,350.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,136.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,456.88
Rate for Payer: UnitedHealthcare Community & State	$234.07
Rate for Payer: Wellpoint Medicaid Managed Care	$257.38

STEM FEMUR P.S CEMENTED LEFTS3

Facility

$7,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681469
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

STEM FEMUR P.S CEMENTED LEFTS3

Facility

$7,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681469
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

STEM FEM WAGNER CN 125D 20MM

Facility

$17,460.00

Service Code	HCPCS C1776
Hospital Charge Code	270698589
Hospital Revenue Code	278
Min. Negotiated Rate	$2,619.00
Max. Negotiated Rate	$4,225.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,225.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,841.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,619.00

STEM FEM WAGNER CN 125D 20MM

Facility

$17,460.00

Service Code	HCPCS C1776
Hospital Charge Code	270698589
Hospital Revenue Code	278
Min. Negotiated Rate	$420.79
Max. Negotiated Rate	$8,730.00
Rate for Payer: Aetna Commercial	$6,634.80
Rate for Payer: Aetna Medicare Advantage	$5,238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,452.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,452.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,452.30
Rate for Payer: Cigna Commercial	$8,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,225.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,841.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,619.00
Rate for Payer: UnitedHealthcare Community & State	$420.79
Rate for Payer: Wellpoint Medicaid Managed Care	$462.69

STEM FINNED 14MM

Facility

$5,400.00

Hospital Charge Code	270666200
Hospital Revenue Code	278
Min. Negotiated Rate	$130.14
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$130.14
Rate for Payer: Wellpoint Medicaid Managed Care	$143.10

STEM FINNED 14MM

Facility

$5,400.00

Hospital Charge Code	270666200
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED 14x80MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270672168
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,324.40
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

STEM FINNED 14x80MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270672168
Hospital Revenue Code	278
Min. Negotiated Rate	$145.08
Max. Negotiated Rate	$3,010.00
Rate for Payer: Aetna Commercial	$2,287.60
Rate for Payer: Aetna Medicare Advantage	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,535.10
Rate for Payer: Cigna Commercial	$3,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,324.40
Rate for Payer: Qualcare PPO/HMO/WC	$903.00
Rate for Payer: UnitedHealthcare Community & State	$145.08
Rate for Payer: Wellpoint Medicaid Managed Care	$159.53

STEM FINNED 17MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270672314
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED 17MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270672314
Hospital Revenue Code	278
Min. Negotiated Rate	$130.14
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$130.14
Rate for Payer: Wellpoint Medicaid Managed Care	$143.10

STEM FINNED 24MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676611
Hospital Revenue Code	278
Min. Negotiated Rate	$145.08
Max. Negotiated Rate	$3,010.00
Rate for Payer: Aetna Commercial	$2,287.60
Rate for Payer: Aetna Medicare Advantage	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,535.10
Rate for Payer: Cigna Commercial	$3,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,324.40
Rate for Payer: Qualcare PPO/HMO/WC	$903.00
Rate for Payer: UnitedHealthcare Community & State	$145.08
Rate for Payer: Wellpoint Medicaid Managed Care	$159.53

STEM FINNED 24MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676611
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,324.40
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

STEM FINNED CEMENTLESS 18MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676167
Hospital Revenue Code	278
Min. Negotiated Rate	$130.14
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$130.14
Rate for Payer: Wellpoint Medicaid Managed Care	$143.10

STEM FINNED CEMENTLESS 18MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676167
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED SHOULDER 20MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676365
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED SHOULDER 20MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676365
Hospital Revenue Code	278
Min. Negotiated Rate	$130.14
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$130.14
Rate for Payer: Wellpoint Medicaid Managed Care	$143.10

STEM FINNED SHOULDER 21MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676632
Hospital Revenue Code	278
Min. Negotiated Rate	$130.14
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$130.14
Rate for Payer: Wellpoint Medicaid Managed Care	$143.10

Know your out-of-pocket cost for care.

All Charges