Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM HIP ANGL SZ3 30x102MM

Facility

$25,265.50

Service Code	HCPCS C1776
Hospital Charge Code	270676775
Hospital Revenue Code	278
Min. Negotiated Rate	$3,789.82
Max. Negotiated Rate	$6,114.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,053.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,114.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,558.41
Rate for Payer: Qualcare PPO/HMO/WC	$3,789.82

STEM HIP ANGL SZ3 30x102MM

Facility

$25,265.50

Service Code	HCPCS C1776
Hospital Charge Code	270676775
Hospital Revenue Code	278
Min. Negotiated Rate	$608.90
Max. Negotiated Rate	$12,632.75
Rate for Payer: Aetna Commercial	$9,600.89
Rate for Payer: Aetna Medicare Advantage	$7,579.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,442.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,442.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,053.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,442.70
Rate for Payer: Cigna Commercial	$12,632.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,114.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,558.41
Rate for Payer: Qualcare PPO/HMO/WC	$3,789.82
Rate for Payer: UnitedHealthcare Community & State	$608.90
Rate for Payer: Wellpoint Medicaid Managed Care	$669.54

STEM HIP ANGL SZ5 35x108MM

Facility

$26,022.75

Service Code	HCPCS C1776
Hospital Charge Code	270678863
Hospital Revenue Code	278
Min. Negotiated Rate	$3,903.41
Max. Negotiated Rate	$6,297.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,204.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,297.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,725.01
Rate for Payer: Qualcare PPO/HMO/WC	$3,903.41

STEM HIP ANGL SZ5 35x108MM

Facility

$26,022.75

Service Code	HCPCS C1776
Hospital Charge Code	270678863
Hospital Revenue Code	278
Min. Negotiated Rate	$627.15
Max. Negotiated Rate	$13,011.38
Rate for Payer: Aetna Commercial	$9,888.65
Rate for Payer: Aetna Medicare Advantage	$7,806.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,635.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,635.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,204.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,635.80
Rate for Payer: Cigna Commercial	$13,011.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,297.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,725.01
Rate for Payer: Qualcare PPO/HMO/WC	$3,903.41
Rate for Payer: UnitedHealthcare Community & State	$627.15
Rate for Payer: Wellpoint Medicaid Managed Care	$689.60

STEM HIP ANGL SZ6 35x111MM

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677352
Hospital Revenue Code	278
Min. Negotiated Rate	$933.49
Max. Negotiated Rate	$19,366.97
Rate for Payer: Aetna Commercial	$14,718.90
Rate for Payer: Aetna Medicare Advantage	$11,620.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,877.16
Rate for Payer: Cigna Commercial	$19,366.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,521.47
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09
Rate for Payer: UnitedHealthcare Community & State	$933.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1,026.45

STEM HIP ANGL SZ6 35x111MM

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677352
Hospital Revenue Code	278
Min. Negotiated Rate	$5,810.09
Max. Negotiated Rate	$9,373.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,521.47
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09

STEM HIP ANGL SZ9 37x120MM

Facility

$12,033.00

Service Code	HCPCS C1776
Hospital Charge Code	270677484
Hospital Revenue Code	278
Min. Negotiated Rate	$290.00
Max. Negotiated Rate	$6,016.50
Rate for Payer: Aetna Commercial	$4,572.54
Rate for Payer: Aetna Medicare Advantage	$3,609.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,068.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,068.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,068.41
Rate for Payer: Cigna Commercial	$6,016.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,911.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,647.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.95
Rate for Payer: UnitedHealthcare Community & State	$290.00
Rate for Payer: Wellpoint Medicaid Managed Care	$318.87

STEM HIP ANGL SZ9 37x120MM

Facility

$12,033.00

Service Code	HCPCS C1776
Hospital Charge Code	270677484
Hospital Revenue Code	278
Min. Negotiated Rate	$1,804.95
Max. Negotiated Rate	$2,911.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,911.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,647.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.95

STEM HIP HIGH OFFSET SZ2 99MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700712
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

STEM HIP HIGH OFFSET SZ2 99MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700712
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP INSIGINIA OFFSET SZ6

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700625
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 HIP INSIGINIA OFFSET SZ6

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700625
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 INSIGNIA SZ7 38X109MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700768
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP INSIGNIA SZ7 38X109MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700768
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

STEM HIP NECK ANGLE 30MM SZ2

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677398
Hospital Revenue Code	278
Min. Negotiated Rate	$933.49
Max. Negotiated Rate	$19,366.97
Rate for Payer: Aetna Commercial	$14,718.90
Rate for Payer: Aetna Medicare Advantage	$11,620.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,877.16
Rate for Payer: Cigna Commercial	$19,366.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,521.47
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09
Rate for Payer: UnitedHealthcare Community & State	$933.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1,026.45

STEM HIP NECK ANGLE 30MM SZ2

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677398
Hospital Revenue Code	278
Min. Negotiated Rate	$5,810.09
Max. Negotiated Rate	$9,373.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,521.47
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09

STEM HIP OFFSET HIGH SZ7 109MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700466
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 HIP OFFSET HIGH SZ7 109MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700466
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 SECURE FIT #7 30x130M

Facility

$12,957.00

Service Code	HCPCS C1776
Hospital Charge Code	270676938
Hospital Revenue Code	278
Min. Negotiated Rate	$1,943.55
Max. Negotiated Rate	$3,135.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,591.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,850.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,943.55

STEM HIP SECURE FIT #7 30x130M

Facility

$12,957.00

Service Code	HCPCS C1776
Hospital Charge Code	270676938
Hospital Revenue Code	278
Min. Negotiated Rate	$312.26
Max. Negotiated Rate	$6,478.50
Rate for Payer: Aetna Commercial	$4,923.66
Rate for Payer: Aetna Medicare Advantage	$3,887.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,304.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,304.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,591.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,304.03
Rate for Payer: Cigna Commercial	$6,478.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,850.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,943.55
Rate for Payer: UnitedHealthcare Community & State	$312.26
Rate for Payer: Wellpoint Medicaid Managed Care	$343.36

STEM HIP SZ10 35X46X160X16MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270670749
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 SZ10 35X46X160X16MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270670749
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 SZ10 40MM

Facility

$33,007.00

Service Code	HCPCS C1776
Hospital Charge Code	270677226
Hospital Revenue Code	278
Min. Negotiated Rate	$795.47
Max. Negotiated Rate	$16,503.50
Rate for Payer: Aetna Commercial	$12,542.66
Rate for Payer: Aetna Medicare Advantage	$9,902.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,416.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,416.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,416.78
Rate for Payer: Cigna Commercial	$16,503.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,987.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,261.54
Rate for Payer: Qualcare PPO/HMO/WC	$4,951.05
Rate for Payer: UnitedHealthcare Community & State	$795.47
Rate for Payer: Wellpoint Medicaid Managed Care	$874.69

STEM HIP SZ10 40MM

Facility

$33,007.00

Service Code	HCPCS C1776
Hospital Charge Code	270677226
Hospital Revenue Code	278
Min. Negotiated Rate	$4,951.05
Max. Negotiated Rate	$7,987.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,601.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,987.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,261.54
Rate for Payer: Qualcare PPO/HMO/WC	$4,951.05

STEM HIP SZ10 C-TPR 35x155MM

Facility

$20,948.95

Service Code	HCPCS C1776
Hospital Charge Code	270680586
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.34
Max. Negotiated Rate	$5,069.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,189.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,608.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.34

Know your out-of-pocket cost for care.

All Charges