Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM INTGRAL POROUS 10 X170310

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270639542
Hospital Revenue Code	278
Min. Negotiated Rate	$2,877.00
Max. Negotiated Rate	$4,641.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,641.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,219.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,877.00

STEM INTGRAL POROUS 10 X170310

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270639542
Hospital Revenue Code	278
Min. Negotiated Rate	$462.24
Max. Negotiated Rate	$9,590.00
Rate for Payer: Aetna Commercial	$7,288.40
Rate for Payer: Aetna Medicare Advantage	$5,754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,890.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,890.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,890.90
Rate for Payer: Cigna Commercial	$9,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,641.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,219.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,877.00
Rate for Payer: UnitedHealthcare Community & State	$462.24
Rate for Payer: Wellpoint Medicaid Managed Care	$508.27

STEM INTGRL 9MMx12 X12-171309

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270658427
Hospital Revenue Code	278
Min. Negotiated Rate	$295.23
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$4,655.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,695.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50
Rate for Payer: UnitedHealthcare Community & State	$295.23
Rate for Payer: Wellpoint Medicaid Managed Care	$324.62

STEM INTGRL 9MMx12 X12-171309

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270658427
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,695.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM KNEE SMOOTH BMT

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270692339
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

STEM KNEE SMOOTH BMT

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270692339
Hospital Revenue Code	278
Min. Negotiated Rate	$183.64
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$183.64
Rate for Payer: Wellpoint Medicaid Managed Care	$201.93

STEM KNEE SMTH W/SCREW 10x80mm

Facility

$8,075.00

Hospital Charge Code	270665689
Hospital Revenue Code	278
Min. Negotiated Rate	$194.61
Max. Negotiated Rate	$4,037.50
Rate for Payer: Aetna Commercial	$3,068.50
Rate for Payer: Aetna Medicare Advantage	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,059.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,059.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,059.12
Rate for Payer: Cigna Commercial	$4,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,954.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,776.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,211.25
Rate for Payer: UnitedHealthcare Community & State	$194.61
Rate for Payer: Wellpoint Medicaid Managed Care	$213.99

STEM KNEE SMTH W/SCREW 10x80mm

Facility

$8,075.00

Hospital Charge Code	270665689
Hospital Revenue Code	278
Min. Negotiated Rate	$1,211.25
Max. Negotiated Rate	$1,954.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,954.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,776.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,211.25

STEM KNEE SMTH W/SCREW 12x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647561
Hospital Revenue Code	278
Min. Negotiated Rate	$183.64
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$183.64
Rate for Payer: Wellpoint Medicaid Managed Care	$201.93

STEM KNEE SMTH W/SCREW 12x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647561
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

STEM KNEE SMTH W/SCREW 16x120m

Facility

$8,315.00

Hospital Charge Code	270675557
Hospital Revenue Code	278
Min. Negotiated Rate	$200.39
Max. Negotiated Rate	$4,157.50
Rate for Payer: Aetna Commercial	$3,159.70
Rate for Payer: Aetna Medicare Advantage	$2,494.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,120.32
Rate for Payer: Cigna Commercial	$4,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,012.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,829.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,247.25
Rate for Payer: UnitedHealthcare Community & State	$200.39
Rate for Payer: Wellpoint Medicaid Managed Care	$220.35

STEM KNEE SMTH W/SCREW 16x120m

Facility

$8,315.00

Hospital Charge Code	270675557
Hospital Revenue Code	278
Min. Negotiated Rate	$1,247.25
Max. Negotiated Rate	$2,012.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,663.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,012.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,829.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,247.25

STEM KNEE SMTH W/SCREW 16x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647560
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

STEM KNEE SMTH W/SCREW 16x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647560
Hospital Revenue Code	278
Min. Negotiated Rate	$183.64
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$183.64
Rate for Payer: Wellpoint Medicaid Managed Care	$201.93

STEM KNEE SMTH W/SCREW 18x80mm

Facility

$8,565.00

Service Code	HCPCS C1776
Hospital Charge Code	270669893
Hospital Revenue Code	278
Min. Negotiated Rate	$1,284.75
Max. Negotiated Rate	$2,072.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,713.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,072.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,884.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,284.75

STEM KNEE SMTH W/SCREW 18x80mm

Facility

$8,565.00

Service Code	HCPCS C1776
Hospital Charge Code	270669893
Hospital Revenue Code	278
Min. Negotiated Rate	$206.42
Max. Negotiated Rate	$4,282.50
Rate for Payer: Aetna Commercial	$3,254.70
Rate for Payer: Aetna Medicare Advantage	$2,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,184.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,184.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,713.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,184.07
Rate for Payer: Cigna Commercial	$4,282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,072.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,884.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,284.75
Rate for Payer: UnitedHealthcare Community & State	$206.42
Rate for Payer: Wellpoint Medicaid Managed Care	$226.97

STEM KNEE SMTH W/SCREW 20x120m

Facility

$8,480.00

Hospital Charge Code	270669894
Hospital Revenue Code	278
Min. Negotiated Rate	$1,272.00
Max. Negotiated Rate	$2,052.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,052.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,865.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.00

STEM KNEE SMTH W/SCREW 20x120m

Facility

$8,480.00

Hospital Charge Code	270669894
Hospital Revenue Code	278
Min. Negotiated Rate	$204.37
Max. Negotiated Rate	$4,240.00
Rate for Payer: Aetna Commercial	$3,222.40
Rate for Payer: Aetna Medicare Advantage	$2,544.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,162.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,162.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,696.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,162.40
Rate for Payer: Cigna Commercial	$4,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,052.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,865.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.00
Rate for Payer: UnitedHealthcare Community & State	$204.37
Rate for Payer: Wellpoint Medicaid Managed Care	$224.72

STEM KNEE SPLINDE 12X120

Facility

$6,080.00

Hospital Charge Code	270638753
Hospital Revenue Code	278
Min. Negotiated Rate	$912.00
Max. Negotiated Rate	$1,471.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,337.60
Rate for Payer: Qualcare PPO/HMO/WC	$912.00

STEM KNEE SPLINDE 12X120

Facility

$6,080.00

Hospital Charge Code	270638753
Hospital Revenue Code	278
Min. Negotiated Rate	$146.53
Max. Negotiated Rate	$3,040.00
Rate for Payer: Aetna Commercial	$2,310.40
Rate for Payer: Aetna Medicare Advantage	$1,824.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,550.40
Rate for Payer: Cigna Commercial	$3,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,337.60
Rate for Payer: Qualcare PPO/HMO/WC	$912.00
Rate for Payer: UnitedHealthcare Community & State	$146.53
Rate for Payer: Wellpoint Medicaid Managed Care	$161.12

STEM KNEE SPLINDE 16X120

Facility

$6,080.00

Hospital Charge Code	270638754
Hospital Revenue Code	278
Min. Negotiated Rate	$146.53
Max. Negotiated Rate	$3,040.00
Rate for Payer: Aetna Commercial	$2,310.40
Rate for Payer: Aetna Medicare Advantage	$1,824.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,550.40
Rate for Payer: Cigna Commercial	$3,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,337.60
Rate for Payer: Qualcare PPO/HMO/WC	$912.00
Rate for Payer: UnitedHealthcare Community & State	$146.53
Rate for Payer: Wellpoint Medicaid Managed Care	$161.12

STEM KNEE SPLINDE 16X120

Facility

$6,080.00

Hospital Charge Code	270638754
Hospital Revenue Code	278
Min. Negotiated Rate	$912.00
Max. Negotiated Rate	$1,471.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,337.60
Rate for Payer: Qualcare PPO/HMO/WC	$912.00

STEM MAL HEAD CALC LT 11104950

Facility

$39,555.00

Hospital Charge Code	270641514
Hospital Revenue Code	278
Min. Negotiated Rate	$5,933.25
Max. Negotiated Rate	$9,572.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,911.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,572.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,702.10
Rate for Payer: Qualcare PPO/HMO/WC	$5,933.25

STEM MAL HEAD CALC LT 11104950

Facility

$39,555.00

Hospital Charge Code	270641514
Hospital Revenue Code	278
Min. Negotiated Rate	$953.28
Max. Negotiated Rate	$19,777.50
Rate for Payer: Aetna Commercial	$15,030.90
Rate for Payer: Aetna Medicare Advantage	$11,866.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,086.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,086.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,911.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,086.52
Rate for Payer: Cigna Commercial	$19,777.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,572.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,702.10
Rate for Payer: Qualcare PPO/HMO/WC	$5,933.25
Rate for Payer: UnitedHealthcare Community & State	$953.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1,048.21

STEM MALLORY MODULAR DIST 15mm

Facility

$14,225.00

Hospital Charge Code	270645040
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,129.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

Know your out-of-pocket cost for care.

All Charges