Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM MP 180x14MM

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677767
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

STEM MP 180x14MM

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677767
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

STEM MUMERAL 14MM

Facility

$18,885.00

Hospital Charge Code	270649257
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.75
Max. Negotiated Rate	$4,570.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,777.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,570.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,154.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,832.75

STEM MUMERAL 14MM

Facility

$18,885.00

Hospital Charge Code	270649257
Hospital Revenue Code	278
Min. Negotiated Rate	$455.13
Max. Negotiated Rate	$9,442.50
Rate for Payer: Aetna Commercial	$7,176.30
Rate for Payer: Aetna Medicare Advantage	$5,665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,815.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,815.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,777.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,815.68
Rate for Payer: Cigna Commercial	$9,442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,570.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,154.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,832.75
Rate for Payer: UnitedHealthcare Community & State	$455.13
Rate for Payer: Wellpoint Medicaid Managed Care	$500.45

STEM NECK ANG SZ7 32X130MM127D

Facility

$11,954.55

Service Code	HCPCS C1776
Hospital Charge Code	270695187
Hospital Revenue Code	278
Min. Negotiated Rate	$1,793.18
Max. Negotiated Rate	$2,893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,893.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,793.18

STEM NECK ANG SZ7 32X130MM127D

Facility

$11,954.55

Service Code	HCPCS C1776
Hospital Charge Code	270695187
Hospital Revenue Code	278
Min. Negotiated Rate	$288.10
Max. Negotiated Rate	$5,977.27
Rate for Payer: Aetna Commercial	$4,542.73
Rate for Payer: Aetna Medicare Advantage	$3,586.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,048.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,048.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,048.41
Rate for Payer: Cigna Commercial	$5,977.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,893.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,793.18
Rate for Payer: UnitedHealthcare Community & State	$288.10
Rate for Payer: Wellpoint Medicaid Managed Care	$316.80

STEM NEXGEN OFFSET EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626696
Hospital Revenue Code	278
Min. Negotiated Rate	$364.09
Max. Negotiated Rate	$587.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$534.00
Rate for Payer: Qualcare PPO/HMO/WC	$364.09

STEM NEXGEN OFFSET EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626696
Hospital Revenue Code	278
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$1,213.62
Rate for Payer: Aetna Commercial	$922.36
Rate for Payer: Aetna Medicare Advantage	$728.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.95
Rate for Payer: Cigna Commercial	$1,213.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$534.00
Rate for Payer: Qualcare PPO/HMO/WC	$364.09
Rate for Payer: UnitedHealthcare Community & State	$58.50
Rate for Payer: Wellpoint Medicaid Managed Care	$64.32

STEM NEXGEN ST EXT 16X145MM

Facility

$6,690.00

Service Code	HCPCS C1776
Hospital Charge Code	270660881
Hospital Revenue Code	278
Min. Negotiated Rate	$1,003.50
Max. Negotiated Rate	$1,618.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,618.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,471.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,003.50

STEM NEXGEN ST EXT 16X145MM

Facility

$6,690.00

Service Code	HCPCS C1776
Hospital Charge Code	270660881
Hospital Revenue Code	278
Min. Negotiated Rate	$161.23
Max. Negotiated Rate	$3,345.00
Rate for Payer: Aetna Commercial	$2,542.20
Rate for Payer: Aetna Medicare Advantage	$2,007.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,705.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,705.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,338.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,705.95
Rate for Payer: Cigna Commercial	$3,345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,618.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,471.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,003.50
Rate for Payer: UnitedHealthcare Community & State	$161.23
Rate for Payer: Wellpoint Medicaid Managed Care	$177.28

STEM NEXGEN STRAIGHT 15X145MM

Facility

$5,245.85

Service Code	HCPCS C1776
Hospital Charge Code	270686914
Hospital Revenue Code	278
Min. Negotiated Rate	$126.42
Max. Negotiated Rate	$2,622.93
Rate for Payer: Aetna Commercial	$1,993.42
Rate for Payer: Aetna Medicare Advantage	$1,573.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,337.69
Rate for Payer: Cigna Commercial	$2,622.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,154.09
Rate for Payer: Qualcare PPO/HMO/WC	$786.88
Rate for Payer: UnitedHealthcare Community & State	$126.42
Rate for Payer: Wellpoint Medicaid Managed Care	$139.02

STEM NEXGEN STRAIGHT 15X145MM

Facility

$5,245.85

Service Code	HCPCS C1776
Hospital Charge Code	270686914
Hospital Revenue Code	278
Min. Negotiated Rate	$786.88
Max. Negotiated Rate	$1,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,154.09
Rate for Payer: Qualcare PPO/HMO/WC	$786.88

STEM NEXGEN STRAIGHT EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626697
Hospital Revenue Code	278
Min. Negotiated Rate	$364.09
Max. Negotiated Rate	$587.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$534.00
Rate for Payer: Qualcare PPO/HMO/WC	$364.09

STEM NEXGEN STRAIGHT EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626697
Hospital Revenue Code	278
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$1,213.62
Rate for Payer: Aetna Commercial	$922.36
Rate for Payer: Aetna Medicare Advantage	$728.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.95
Rate for Payer: Cigna Commercial	$1,213.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$534.00
Rate for Payer: Qualcare PPO/HMO/WC	$364.09
Rate for Payer: UnitedHealthcare Community & State	$58.50
Rate for Payer: Wellpoint Medicaid Managed Care	$64.32

STEM NXG TIBIAL PLATE SZ4 5970

Facility

$8,235.30

Hospital Charge Code	270607473
Hospital Revenue Code	278
Min. Negotiated Rate	$198.47
Max. Negotiated Rate	$4,117.65
Rate for Payer: Aetna Commercial	$3,129.41
Rate for Payer: Aetna Medicare Advantage	$2,470.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,647.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,100.00
Rate for Payer: Cigna Commercial	$4,117.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,992.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,811.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,235.30
Rate for Payer: UnitedHealthcare Community & State	$198.47
Rate for Payer: Wellpoint Medicaid Managed Care	$218.24

STEM NXG TIBIAL PLATE SZ4 5970

Facility

$8,235.30

Hospital Charge Code	270607473
Hospital Revenue Code	278
Min. Negotiated Rate	$1,235.30
Max. Negotiated Rate	$1,992.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,647.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,992.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,811.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,235.30

STEM NXG TIBIAL PLATE SZ4 5980

Facility

$8,017.25

Hospital Charge Code	270608720
Hospital Revenue Code	278
Min. Negotiated Rate	$193.22
Max. Negotiated Rate	$4,008.62
Rate for Payer: Aetna Commercial	$3,046.55
Rate for Payer: Aetna Medicare Advantage	$2,405.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,044.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,044.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,044.40
Rate for Payer: Cigna Commercial	$4,008.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,763.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.59
Rate for Payer: UnitedHealthcare Community & State	$193.22
Rate for Payer: Wellpoint Medicaid Managed Care	$212.46

STEM NXG TIBIAL PLATE SZ4 5980

Facility

$8,017.25

Hospital Charge Code	270608720
Hospital Revenue Code	278
Min. Negotiated Rate	$1,202.59
Max. Negotiated Rate	$1,940.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,763.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.59

STEM NXG TIBIAL PLATE SZ5 5980

Facility

$8,017.25

Hospital Charge Code	270608659
Hospital Revenue Code	278
Min. Negotiated Rate	$193.22
Max. Negotiated Rate	$4,008.62
Rate for Payer: Aetna Commercial	$3,046.55
Rate for Payer: Aetna Medicare Advantage	$2,405.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,044.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,044.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,044.40
Rate for Payer: Cigna Commercial	$4,008.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,763.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.59
Rate for Payer: UnitedHealthcare Community & State	$193.22
Rate for Payer: Wellpoint Medicaid Managed Care	$212.46

STEM NXG TIBIAL PLATE SZ5 5980

Facility

$8,017.25

Hospital Charge Code	270608659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,202.59
Max. Negotiated Rate	$1,940.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,763.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.59

STEM NXG TIBIAL PLATE SZ7 5970

Facility

$4,948.85

Hospital Charge Code	270606758
Hospital Revenue Code	278
Min. Negotiated Rate	$119.27
Max. Negotiated Rate	$2,474.43
Rate for Payer: Aetna Commercial	$1,880.56
Rate for Payer: Aetna Medicare Advantage	$1,484.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,261.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,261.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$989.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,261.96
Rate for Payer: Cigna Commercial	$2,474.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,088.75
Rate for Payer: Qualcare PPO/HMO/WC	$742.33
Rate for Payer: UnitedHealthcare Community & State	$119.27
Rate for Payer: Wellpoint Medicaid Managed Care	$131.14

STEM NXG TIBIAL PLATE SZ7 5970

Facility

$4,948.85

Hospital Charge Code	270606758
Hospital Revenue Code	278
Min. Negotiated Rate	$742.33
Max. Negotiated Rate	$1,197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$989.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,088.75
Rate for Payer: Qualcare PPO/HMO/WC	$742.33

STEM NXG TIBIAL PLATE SZ7 5980

Facility

$7,647.25

Hospital Charge Code	270607175
Hospital Revenue Code	278
Min. Negotiated Rate	$1,147.09
Max. Negotiated Rate	$1,850.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,529.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,850.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,682.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,147.09

STEM NXG TIBIAL PLATE SZ7 5980

Facility

$7,647.25

Hospital Charge Code	270607175
Hospital Revenue Code	278
Min. Negotiated Rate	$184.30
Max. Negotiated Rate	$3,823.62
Rate for Payer: Aetna Commercial	$2,905.95
Rate for Payer: Aetna Medicare Advantage	$2,294.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,950.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,950.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,529.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,950.05
Rate for Payer: Cigna Commercial	$3,823.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,850.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,682.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,147.09
Rate for Payer: UnitedHealthcare Community & State	$184.30
Rate for Payer: Wellpoint Medicaid Managed Care	$202.65

STEM NXG TIBIAL PLATE SZ8 5980

Facility

$7,353.15

Hospital Charge Code	270606476
Hospital Revenue Code	278
Min. Negotiated Rate	$177.21
Max. Negotiated Rate	$3,676.57
Rate for Payer: Aetna Commercial	$2,794.20
Rate for Payer: Aetna Medicare Advantage	$2,205.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,875.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,875.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,470.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,875.05
Rate for Payer: Cigna Commercial	$3,676.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,779.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,617.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,102.97
Rate for Payer: UnitedHealthcare Community & State	$177.21
Rate for Payer: Wellpoint Medicaid Managed Care	$194.86

Know your out-of-pocket cost for care.

All Charges