Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$504.87
Max. Negotiated Rate	$10,474.48
Rate for Payer: Aetna Commercial	$7,960.60
Rate for Payer: Aetna Medicare Advantage	$6,284.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,341.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,341.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,189.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,341.98
Rate for Payer: Cigna Commercial	$10,474.48
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
Rate for Payer: UnitedHealthcare Community & State	$504.87
Rate for Payer: Wellpoint Medicaid Managed Care	$555.15

STEM HIP SZ10 C-TPR 40x155MM

Facility

$34,213.50

Service Code	HCPCS C1776
Hospital Charge Code	270672696
Hospital Revenue Code	278
Min. Negotiated Rate	$824.55
Max. Negotiated Rate	$17,106.75
Rate for Payer: Aetna Commercial	$13,001.13
Rate for Payer: Aetna Medicare Advantage	$10,264.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,724.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,724.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,842.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,724.44
Rate for Payer: Cigna Commercial	$17,106.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,279.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,526.97
Rate for Payer: Qualcare PPO/HMO/WC	$5,132.02
Rate for Payer: UnitedHealthcare Community & State	$824.55
Rate for Payer: Wellpoint Medicaid Managed Care	$906.66

STEM HIP SZ10 C-TPR 40x155MM

Facility

$34,213.50

Service Code	HCPCS C1776
Hospital Charge Code	270672696
Hospital Revenue Code	278
Min. Negotiated Rate	$5,132.02
Max. Negotiated Rate	$8,279.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,842.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,279.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,526.97
Rate for Payer: Qualcare PPO/HMO/WC	$5,132.02

STEM HIP SZ6 DEG 127 28MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673425
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 SZ6 DEG 127 28MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673425
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 SZ7 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678035
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$7,481.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,801.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

STEM HIP SZ7 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678035
Hospital Revenue Code	278
Min. Negotiated Rate	$745.11
Max. Negotiated Rate	$15,458.62
Rate for Payer: Aetna Commercial	$11,748.56
Rate for Payer: Aetna Medicare Advantage	$9,275.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,883.90
Rate for Payer: Cigna Commercial	$15,458.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,801.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59
Rate for Payer: UnitedHealthcare Community & State	$745.11
Rate for Payer: Wellpoint Medicaid Managed Care	$819.31

STEM HIP SZ8 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678226
Hospital Revenue Code	278
Min. Negotiated Rate	$745.11
Max. Negotiated Rate	$15,458.62
Rate for Payer: Aetna Commercial	$11,748.56
Rate for Payer: Aetna Medicare Advantage	$9,275.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,883.90
Rate for Payer: Cigna Commercial	$15,458.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,801.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59
Rate for Payer: UnitedHealthcare Community & State	$745.11
Rate for Payer: Wellpoint Medicaid Managed Care	$819.31

STEM HIP SZ8 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678226
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$7,481.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,801.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

STEM HIP SZ 9 C-TPR 40x205MM

Facility

$16,826.25

Hospital Charge Code	270676953
Hospital Revenue Code	278
Min. Negotiated Rate	$2,523.94
Max. Negotiated Rate	$4,071.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,365.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,701.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,523.94

STEM HIP SZ 9 C-TPR 40x205MM

Facility

$16,826.25

Hospital Charge Code	270676953
Hospital Revenue Code	278
Min. Negotiated Rate	$405.51
Max. Negotiated Rate	$8,413.12
Rate for Payer: Aetna Commercial	$6,393.98
Rate for Payer: Aetna Medicare Advantage	$5,047.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,290.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,290.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,365.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,290.69
Rate for Payer: Cigna Commercial	$8,413.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,701.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,523.94
Rate for Payer: UnitedHealthcare Community & State	$405.51
Rate for Payer: Wellpoint Medicaid Managed Care	$445.90

STEM HUM 8MM COMP STD

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693793
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM HUM 8MM COMP STD

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693793
Hospital Revenue Code	278
Min. Negotiated Rate	$349.45
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$349.45
Rate for Payer: Wellpoint Medicaid Managed Care	$384.25

STEM HUM BIOMOD 6x115 11113700

Facility

$15,585.00

Hospital Charge Code	270641367
Hospital Revenue Code	278
Min. Negotiated Rate	$375.60
Max. Negotiated Rate	$7,792.50
Rate for Payer: Aetna Commercial	$5,922.30
Rate for Payer: Aetna Medicare Advantage	$4,675.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,974.18
Rate for Payer: Cigna Commercial	$7,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,428.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75
Rate for Payer: UnitedHealthcare Community & State	$375.60
Rate for Payer: Wellpoint Medicaid Managed Care	$413.00

STEM HUM BIOMOD 6x115 11113700

Facility

$15,585.00

Hospital Charge Code	270641367
Hospital Revenue Code	278
Min. Negotiated Rate	$2,337.75
Max. Negotiated Rate	$3,771.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,428.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75

STEM HUM COMP PRIM STD 13MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698391
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM HUM COMP PRIM STD 13MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698391
Hospital Revenue Code	278
Min. Negotiated Rate	$349.45
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,190.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$349.45
Rate for Payer: Wellpoint Medicaid Managed Care	$384.25

STEM HUM COMPR PPS 8X122MM

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695299
Hospital Revenue Code	278
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

STEM HUM COMPR PPS 8X122MM

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695299
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

STEM HUMERAL

Facility

$27,625.00

Hospital Charge Code	270661830
Hospital Revenue Code	278
Min. Negotiated Rate	$4,143.75
Max. Negotiated Rate	$6,685.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,685.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,077.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,143.75

STEM HUMERAL

Facility

$27,625.00

Hospital Charge Code	270661830
Hospital Revenue Code	278
Min. Negotiated Rate	$665.76
Max. Negotiated Rate	$13,812.50
Rate for Payer: Aetna Commercial	$10,497.50
Rate for Payer: Aetna Medicare Advantage	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,044.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,044.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,044.38
Rate for Payer: Cigna Commercial	$13,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,685.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,077.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,143.75
Rate for Payer: UnitedHealthcare Community & State	$665.76
Rate for Payer: Wellpoint Medicaid Managed Care	$732.06

STEM HUMERAL

Facility

$27,640.00

Hospital Charge Code	270640742
Hospital Revenue Code	278
Min. Negotiated Rate	$666.12
Max. Negotiated Rate	$13,820.00
Rate for Payer: Aetna Commercial	$10,503.20
Rate for Payer: Aetna Medicare Advantage	$8,292.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,048.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,048.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,048.20
Rate for Payer: Cigna Commercial	$13,820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,688.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,080.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,146.00
Rate for Payer: UnitedHealthcare Community & State	$666.12
Rate for Payer: Wellpoint Medicaid Managed Care	$732.46

STEM HUMERAL

Facility

$27,640.00

Hospital Charge Code	270640742
Hospital Revenue Code	278
Min. Negotiated Rate	$4,146.00
Max. Negotiated Rate	$6,688.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,528.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,688.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,080.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,146.00

STEM HUMERAL 10MM

Facility

$11,175.00

Hospital Charge Code	270672288
Hospital Revenue Code	278
Min. Negotiated Rate	$269.32
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,458.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$269.32
Rate for Payer: Wellpoint Medicaid Managed Care	$296.14

STEM HUMERAL 10MM

Facility

$11,175.00

Hospital Charge Code	270672288
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,458.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

Know your out-of-pocket cost for care.

All Charges