Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM FINNED SHOULDER 21MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676632
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 FLUTED EXTENSION 14x40MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270668739
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 FLUTED EXTENSION 14x40MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270668739
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 FML12x140FBR CL ST 784512

Facility

$20,300.20

Hospital Charge Code	270639261
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 FML12x140FBR CL ST 784512

Facility

$20,300.20

Hospital Charge Code	270639261
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 FM MC 13x140 STD 784513

Facility

$19,519.40

Hospital Charge Code	270638550
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 FM MC 13x140 STD 784513

Facility

$19,519.40

Hospital Charge Code	270638550
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 G7 OSSEOTI MULTI 62MM

Facility

$18,980.00

Service Code	HCPCS C1776
Hospital Charge Code	270690941
Hospital Revenue Code	278
Min. Negotiated Rate	$2,847.00
Max. Negotiated Rate	$4,593.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,796.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,593.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,175.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,847.00

STEM G7 OSSEOTI MULTI 62MM

Facility

$18,980.00

Service Code	HCPCS C1776
Hospital Charge Code	270690941
Hospital Revenue Code	278
Min. Negotiated Rate	$457.42
Max. Negotiated Rate	$9,490.00
Rate for Payer: Aetna Commercial	$7,212.40
Rate for Payer: Aetna Medicare Advantage	$5,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,839.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,839.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,796.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,839.90
Rate for Payer: Cigna Commercial	$9,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,593.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,175.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,847.00
Rate for Payer: UnitedHealthcare Community & State	$457.42
Rate for Payer: Wellpoint Medicaid Managed Care	$502.97

STEM G7 OSSEOTI MULTIHOLE 56 M

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270688679
Hospital Revenue Code	278
Min. Negotiated Rate	$2,848.50
Max. Negotiated Rate	$4,595.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,177.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50

STEM G7 OSSEOTI MULTIHOLE 56 M

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270688679
Hospital Revenue Code	278
Min. Negotiated Rate	$457.66
Max. Negotiated Rate	$9,495.00
Rate for Payer: Aetna Commercial	$7,216.20
Rate for Payer: Aetna Medicare Advantage	$5,697.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,842.45
Rate for Payer: Cigna Commercial	$9,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,177.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50
Rate for Payer: UnitedHealthcare Community & State	$457.66
Rate for Payer: Wellpoint Medicaid Managed Care	$503.24

STEMHEAD 12X0MMX2.0MM

Facility

$12,165.00

Service Code	HCPCS C1776
Hospital Charge Code	270693318
Hospital Revenue Code	278
Min. Negotiated Rate	$293.18
Max. Negotiated Rate	$6,082.50
Rate for Payer: Aetna Commercial	$4,622.70
Rate for Payer: Aetna Medicare Advantage	$3,649.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.07
Rate for Payer: Cigna Commercial	$6,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75
Rate for Payer: UnitedHealthcare Community & State	$293.18
Rate for Payer: Wellpoint Medicaid Managed Care	$322.37

STEMHEAD 12X0MMX2.0MM

Facility

$12,165.00

Service Code	HCPCS C1776
Hospital Charge Code	270693318
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.75
Max. Negotiated Rate	$2,943.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75

STEM HIGH OFFSET SZ4 36X103MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700615
Hospital Revenue Code	278
Min. Negotiated Rate	$1,840.50
Max. Negotiated Rate	$2,969.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,969.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,699.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,840.50

STEM HIGH OFFSET SZ4 36X103MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700615
Hospital Revenue Code	278
Min. Negotiated Rate	$295.71
Max. Negotiated Rate	$6,135.00
Rate for Payer: Aetna Commercial	$4,662.60
Rate for Payer: Aetna Medicare Advantage	$3,681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,128.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,128.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,128.85
Rate for Payer: Cigna Commercial	$6,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,969.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,699.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,840.50
Rate for Payer: UnitedHealthcare Community & State	$295.71
Rate for Payer: Wellpoint Medicaid Managed Care	$325.15

STEM HIP 127 DEG SZ9 DIST 15MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673478
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

STEM HIP 127 DEG SZ9 DIST 15MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673478
Hospital Revenue Code	278
Min. Negotiated Rate	$357.88
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$5,643.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50
Rate for Payer: UnitedHealthcare Community & State	$357.88
Rate for Payer: Wellpoint Medicaid Managed Care	$393.52

STEM HIP ACCO 127D NCK ANG SZ8

Facility

$9,831.20

Service Code	HCPCS C1776
Hospital Charge Code	270699505
Hospital Revenue Code	278
Min. Negotiated Rate	$236.93
Max. Negotiated Rate	$4,915.60
Rate for Payer: Aetna Commercial	$3,735.86
Rate for Payer: Aetna Medicare Advantage	$2,949.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,506.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,506.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,966.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,506.96
Rate for Payer: Cigna Commercial	$4,915.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,379.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,162.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,474.68
Rate for Payer: UnitedHealthcare Community & State	$236.93
Rate for Payer: Wellpoint Medicaid Managed Care	$260.53

STEM HIP ACCO 127D NCK ANG SZ8

Facility

$9,831.20

Service Code	HCPCS C1776
Hospital Charge Code	270699505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,474.68
Max. Negotiated Rate	$2,379.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,966.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,379.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,162.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,474.68

STEM HIP AMCA 16 x 200MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683438
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP AMCA 16 x 200MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683438
Hospital Revenue Code	278
Min. Negotiated Rate	$674.80
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$10,640.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00
Rate for Payer: UnitedHealthcare Community & State	$674.80
Rate for Payer: Wellpoint Medicaid Managed Care	$742.00

STEM HIP AMCA 18 x 40MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682863
Hospital Revenue Code	278
Min. Negotiated Rate	$674.80
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$10,640.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00
Rate for Payer: UnitedHealthcare Community & State	$674.80
Rate for Payer: Wellpoint Medicaid Managed Care	$742.00

STEM HIP AMCA 18 x 40MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682863
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP ANGL SZ2 30x99MM

Facility

$11,921.55

Service Code	HCPCS C1776
Hospital Charge Code	270680956
Hospital Revenue Code	278
Min. Negotiated Rate	$1,788.23
Max. Negotiated Rate	$2,885.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,384.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,885.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,622.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,788.23

STEM HIP ANGL SZ2 30x99MM

Facility

$11,921.55

Service Code	HCPCS C1776
Hospital Charge Code	270680956
Hospital Revenue Code	278
Min. Negotiated Rate	$287.31
Max. Negotiated Rate	$5,960.77
Rate for Payer: Aetna Commercial	$4,530.19
Rate for Payer: Aetna Medicare Advantage	$3,576.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,384.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,040.00
Rate for Payer: Cigna Commercial	$5,960.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,885.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,622.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,788.23
Rate for Payer: UnitedHealthcare Community & State	$287.31
Rate for Payer: Wellpoint Medicaid Managed Care	$315.92

Know your out-of-pocket cost for care.

All Charges