Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM MALLORY MODULAR DIST 15mm

Facility

$14,225.00

Hospital Charge Code	270645040
Hospital Revenue Code	278
Min. Negotiated Rate	$342.82
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
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
Rate for Payer: UnitedHealthcare Community & State	$342.82
Rate for Payer: Wellpoint Medicaid Managed Care	$376.96

STEM MALLORY MODULR CALCAR 34B

Facility

$33,545.00

Hospital Charge Code	270645039
Hospital Revenue Code	278
Min. Negotiated Rate	$808.43
Max. Negotiated Rate	$16,772.50
Rate for Payer: Aetna Commercial	$12,747.10
Rate for Payer: Aetna Medicare Advantage	$10,063.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,553.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,553.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,553.98
Rate for Payer: Cigna Commercial	$16,772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,117.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,379.90
Rate for Payer: Qualcare PPO/HMO/WC	$5,031.75
Rate for Payer: UnitedHealthcare Community & State	$808.43
Rate for Payer: Wellpoint Medicaid Managed Care	$888.94

STEM MALLORY MODULR CALCAR 34B

Facility

$33,545.00

Hospital Charge Code	270645039
Hospital Revenue Code	278
Min. Negotiated Rate	$5,031.75
Max. Negotiated Rate	$8,117.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,117.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,379.90
Rate for Payer: Qualcare PPO/HMO/WC	$5,031.75

STEM MALRY 45B MOD PROX 108132

Facility

$23,188.00

Hospital Charge Code	270633599
Hospital Revenue Code	278
Min. Negotiated Rate	$3,478.20
Max. Negotiated Rate	$5,611.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,637.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,611.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,101.36
Rate for Payer: Qualcare PPO/HMO/WC	$3,478.20

STEM MALRY 45B MOD PROX 108132

Facility

$23,188.00

Hospital Charge Code	270633599
Hospital Revenue Code	278
Min. Negotiated Rate	$558.83
Max. Negotiated Rate	$11,594.00
Rate for Payer: Aetna Commercial	$8,811.44
Rate for Payer: Aetna Medicare Advantage	$6,956.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,912.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,912.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,637.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,912.94
Rate for Payer: Cigna Commercial	$11,594.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,611.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,101.36
Rate for Payer: Qualcare PPO/HMO/WC	$3,478.20
Rate for Payer: UnitedHealthcare Community & State	$558.83
Rate for Payer: Wellpoint Medicaid Managed Care	$614.48

STEM METATARSAL LARGE

Facility

$8,750.00

Hospital Charge Code	270672046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

STEM METATARSAL LARGE

Facility

$8,750.00

Hospital Charge Code	270672046
Hospital Revenue Code	278
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

STEM METATARSEL SML POROUS CTD

Facility

$7,225.00

Hospital Charge Code	270642724
Hospital Revenue Code	278
Min. Negotiated Rate	$174.12
Max. Negotiated Rate	$3,612.50
Rate for Payer: Aetna Commercial	$2,745.50
Rate for Payer: Aetna Medicare Advantage	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,842.38
Rate for Payer: Cigna Commercial	$3,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,589.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75
Rate for Payer: UnitedHealthcare Community & State	$174.12
Rate for Payer: Wellpoint Medicaid Managed Care	$191.46

STEM METATARSEL SML POROUS CTD

Facility

$7,225.00

Hospital Charge Code	270642724
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.75
Max. Negotiated Rate	$1,748.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,589.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75

STEM MINI COMP PRIMARY 14MM

Facility

$14,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270700041
Hospital Revenue Code	278
Min. Negotiated Rate	$2,240.25
Max. Negotiated Rate	$3,614.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,987.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,614.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,285.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,240.25

STEM MINI COMP PRIMARY 14MM

Facility

$14,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270700041
Hospital Revenue Code	278
Min. Negotiated Rate	$359.93
Max. Negotiated Rate	$7,467.50
Rate for Payer: Aetna Commercial	$5,675.30
Rate for Payer: Aetna Medicare Advantage	$4,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,808.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,808.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,808.43
Rate for Payer: Cigna Commercial	$7,467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,614.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,285.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,240.25
Rate for Payer: UnitedHealthcare Community & State	$359.93
Rate for Payer: Wellpoint Medicaid Managed Care	$395.78

STEM MINI HUMERAL

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	270692525
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

STEM MINI HUMERAL

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	270692525
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

STEM MOD ARCOS 17X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694444
Hospital Revenue Code	278
Min. Negotiated Rate	$449.71
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,105.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$449.71
Rate for Payer: Wellpoint Medicaid Managed Care	$494.49

STEM MOD ARCOS 17X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694444
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,105.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

STEM MOD COMPR 14X150MM

Facility

$18,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270697379
Hospital Revenue Code	278
Min. Negotiated Rate	$438.14
Max. Negotiated Rate	$9,090.00
Rate for Payer: Aetna Commercial	$6,908.40
Rate for Payer: Aetna Medicare Advantage	$5,454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,635.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,635.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,636.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,635.90
Rate for Payer: Cigna Commercial	$9,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,399.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,999.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,727.00
Rate for Payer: UnitedHealthcare Community & State	$438.14
Rate for Payer: Wellpoint Medicaid Managed Care	$481.77

STEM MOD COMPR 14X150MM

Facility

$18,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270697379
Hospital Revenue Code	278
Min. Negotiated Rate	$2,727.00
Max. Negotiated Rate	$4,399.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,636.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,399.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,999.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,727.00

STEM MODULAR 40mm WITH SCREW

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270646503
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

STEM MODULAR 40mm WITH SCREW

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270646503
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

STEM MOLD 13mmX145mm W/REINFO

Facility

$8,495.00

Hospital Charge Code	270646449
Hospital Revenue Code	278
Min. Negotiated Rate	$204.73
Max. Negotiated Rate	$4,247.50
Rate for Payer: Aetna Commercial	$3,228.10
Rate for Payer: Aetna Medicare Advantage	$2,548.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.22
Rate for Payer: Cigna Commercial	$4,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,868.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25
Rate for Payer: UnitedHealthcare Community & State	$204.73
Rate for Payer: Wellpoint Medicaid Managed Care	$225.12

STEM MOLD 13mmX145mm W/REINFO

Facility

$8,495.00

Hospital Charge Code	270646449
Hospital Revenue Code	278
Min. Negotiated Rate	$1,274.25
Max. Negotiated Rate	$2,055.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,868.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25

STEM MOLD 15 MM x 155MM W/REIN

Facility

$8,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270686605
Hospital Revenue Code	278
Min. Negotiated Rate	$1,274.25
Max. Negotiated Rate	$2,055.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,868.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25

STEM MOLD 15 MM x 155MM W/REIN

Facility

$8,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270686605
Hospital Revenue Code	278
Min. Negotiated Rate	$204.73
Max. Negotiated Rate	$4,247.50
Rate for Payer: Aetna Commercial	$3,228.10
Rate for Payer: Aetna Medicare Advantage	$2,548.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.22
Rate for Payer: Cigna Commercial	$4,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,868.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25
Rate for Payer: UnitedHealthcare Community & State	$204.73
Rate for Payer: Wellpoint Medicaid Managed Care	$225.12

STEM MOLD 48MM WITH INSERT

Facility

$6,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270646450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,019.25
Max. Negotiated Rate	$1,644.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,644.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,494.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,019.25

STEM MOLD 48MM WITH INSERT

Facility

$6,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270646450
Hospital Revenue Code	278
Min. Negotiated Rate	$163.76
Max. Negotiated Rate	$3,397.50
Rate for Payer: Aetna Commercial	$2,582.10
Rate for Payer: Aetna Medicare Advantage	$2,038.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,732.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,732.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,732.72
Rate for Payer: Cigna Commercial	$3,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,644.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,494.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,019.25
Rate for Payer: UnitedHealthcare Community & State	$163.76
Rate for Payer: Wellpoint Medicaid Managed Care	$180.07

Know your out-of-pocket cost for care.

All Charges