Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM NXG TIBIAL PLATE SZ8 5980

Facility

$7,353.15

Hospital Charge Code	270606476
Hospital Revenue Code	278
Min. Negotiated Rate	$1,102.97
Max. Negotiated Rate	$1,779.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,470.63
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

STEM OSSINTERLOCK BOWD W/SCREW

Facility

$9,895.00

Service Code	HCPCS C1713
Hospital Charge Code	270664285
Hospital Revenue Code	278
Min. Negotiated Rate	$1,484.25
Max. Negotiated Rate	$2,394.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,979.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,394.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,176.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,484.25

STEM OSSINTERLOCK BOWD W/SCREW

Facility

$9,895.00

Service Code	HCPCS C1713
Hospital Charge Code	270664285
Hospital Revenue Code	278
Min. Negotiated Rate	$238.47
Max. Negotiated Rate	$4,947.50
Rate for Payer: Aetna Commercial	$3,760.10
Rate for Payer: Aetna Medicare Advantage	$2,968.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,523.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,523.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,979.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,523.22
Rate for Payer: Cigna Commercial	$4,947.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,394.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,176.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,484.25
Rate for Payer: UnitedHealthcare Community & State	$238.47
Rate for Payer: Wellpoint Medicaid Managed Care	$262.22

STEM OSS RESURFACING 6cm RIGHT

Facility

$39,710.00

Hospital Charge Code	270673874
Hospital Revenue Code	278
Min. Negotiated Rate	$957.01
Max. Negotiated Rate	$19,855.00
Rate for Payer: Aetna Commercial	$15,089.80
Rate for Payer: Aetna Medicare Advantage	$11,913.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,126.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,126.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,942.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,126.05
Rate for Payer: Cigna Commercial	$19,855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,609.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,736.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,956.50
Rate for Payer: UnitedHealthcare Community & State	$957.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1,052.32

STEM OSS RESURFACING 6cm RIGHT

Facility

$39,710.00

Hospital Charge Code	270673874
Hospital Revenue Code	278
Min. Negotiated Rate	$5,956.50
Max. Negotiated Rate	$9,609.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,942.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,609.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,736.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,956.50

STEM PERSONA CEMENTE SZ 5

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689501
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

STEM PERSONA CEMENTE SZ 5

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

STEM PERSONA CEMENTE SZ 6

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689590
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

STEM PERSONA CEMENTE SZ 6

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689590
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

STEM PERSONA CEMENTE SZ 7

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686536
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

STEM PERSONA CEMENTE SZ 7

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686536
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

STEM PERSONA TIBIAL 5 DEG SZ1

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686543
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

STEM PERSONA TIBIAL 5 DEG SZ1

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686543
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM PERSONA TIBIAL 5 DEG SZD

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689500
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM PERSONA TIBIAL 5 DEG SZD

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689500
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

STEM PLASMA DISTAL 12x127MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270675958
Hospital Revenue Code	278
Min. Negotiated Rate	$684.92
Max. Negotiated Rate	$14,210.00
Rate for Payer: Aetna Commercial	$10,799.60
Rate for Payer: Aetna Medicare Advantage	$8,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,247.10
Rate for Payer: Cigna Commercial	$14,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,252.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00
Rate for Payer: UnitedHealthcare Community & State	$684.92
Rate for Payer: Wellpoint Medicaid Managed Care	$753.13

STEM PLASMA DISTAL 12x127MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270675958
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.00
Max. Negotiated Rate	$6,877.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,252.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00

STEM POROCOAT STAND SZ8 107MM

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270685582
Hospital Revenue Code	278
Min. Negotiated Rate	$1,657.50
Max. Negotiated Rate	$2,674.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,674.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,431.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,657.50

STEM POROCOAT STAND SZ8 107MM

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270685582
Hospital Revenue Code	278
Min. Negotiated Rate	$266.31
Max. Negotiated Rate	$5,525.00
Rate for Payer: Aetna Commercial	$4,199.00
Rate for Payer: Aetna Medicare Advantage	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,817.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,817.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,817.75
Rate for Payer: Cigna Commercial	$5,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,674.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,431.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,657.50
Rate for Payer: UnitedHealthcare Community & State	$266.31
Rate for Payer: Wellpoint Medicaid Managed Care	$292.82

STEM POROUS 11mm INTEGRAL LAT-

Facility

$19,180.00

Hospital Charge Code	270670961
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 POROUS 11mm INTEGRAL LAT-

Facility

$19,180.00

Hospital Charge Code	270670961
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 POROUS 12mm INTEGRAL LAT-

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270636129
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 POROUS 12mm INTEGRAL LAT-

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270636129
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 POROUS 12mm X11-170315

Facility

$19,915.00

Hospital Charge Code	270643984
Hospital Revenue Code	278
Min. Negotiated Rate	$479.95
Max. Negotiated Rate	$9,957.50
Rate for Payer: Aetna Commercial	$7,567.70
Rate for Payer: Aetna Medicare Advantage	$5,974.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,078.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,078.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,983.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,078.32
Rate for Payer: Cigna Commercial	$9,957.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,819.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,381.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,987.25
Rate for Payer: UnitedHealthcare Community & State	$479.95
Rate for Payer: Wellpoint Medicaid Managed Care	$527.75

STEM POROUS 12mm X11-170315

Facility

$19,915.00

Hospital Charge Code	270643984
Hospital Revenue Code	278
Min. Negotiated Rate	$2,987.25
Max. Negotiated Rate	$4,819.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,983.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,819.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,381.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,987.25

Know your out-of-pocket cost for care.

All Charges