Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM POROUS 13 INTEG X11170313

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270635321
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 13 INTEG X11170313

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270635321
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 9mm X 125mm COLLAR

Facility

$19,180.00

Hospital Charge Code	270646033
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 9mm X 125mm COLLAR

Facility

$19,180.00

Hospital Charge Code	270646033
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 9MMx125MM PROXIMAL

Facility

$19,180.00

Hospital Charge Code	270648760
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 9MMx125MM PROXIMAL

Facility

$19,180.00

Hospital Charge Code	270648760
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 BOWED 14.5x150MM

Facility

$10,515.00

Service Code	HCPCS C1776
Hospital Charge Code	270673719
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.25
Max. Negotiated Rate	$2,544.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.25

STEM POROUS BOWED 14.5x150MM

Facility

$10,515.00

Service Code	HCPCS C1776
Hospital Charge Code	270673719
Hospital Revenue Code	278
Min. Negotiated Rate	$253.41
Max. Negotiated Rate	$5,257.50
Rate for Payer: Aetna Commercial	$3,995.70
Rate for Payer: Aetna Medicare Advantage	$3,154.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.32
Rate for Payer: Cigna Commercial	$5,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.25
Rate for Payer: UnitedHealthcare Community & State	$253.41
Rate for Payer: Wellpoint Medicaid Managed Care	$278.65

STEM POROUS INTEGRAL

Facility

$19,180.00

Hospital Charge Code	270660355
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 INTEGRAL

Facility

$19,180.00

Hospital Charge Code	270660355
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 PORS INGL 16X160 11170316

Facility

$19,175.45

Hospital Charge Code	270634576
Hospital Revenue Code	278
Min. Negotiated Rate	$462.13
Max. Negotiated Rate	$9,587.73
Rate for Payer: Aetna Commercial	$7,286.67
Rate for Payer: Aetna Medicare Advantage	$5,752.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,889.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,889.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,835.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,889.74
Rate for Payer: Cigna Commercial	$9,587.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,218.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,876.32
Rate for Payer: UnitedHealthcare Community & State	$462.13
Rate for Payer: Wellpoint Medicaid Managed Care	$508.15

STEM PORS INGL 16X160 11170316

Facility

$19,175.45

Hospital Charge Code	270634576
Hospital Revenue Code	278
Min. Negotiated Rate	$2,876.32
Max. Negotiated Rate	$4,640.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,835.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,218.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,876.32

STEM PRESSFIT 10 MM

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270688858
Hospital Revenue Code	278
Min. Negotiated Rate	$1,430.33
Max. Negotiated Rate	$2,307.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,097.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33

STEM PRESSFIT 10 MM

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270688858
Hospital Revenue Code	278
Min. Negotiated Rate	$229.81
Max. Negotiated Rate	$4,767.75
Rate for Payer: Aetna Commercial	$3,623.49
Rate for Payer: Aetna Medicare Advantage	$2,860.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,431.55
Rate for Payer: Cigna Commercial	$4,767.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,097.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33
Rate for Payer: UnitedHealthcare Community & State	$229.81
Rate for Payer: Wellpoint Medicaid Managed Care	$252.69

STEM PRESS FIT SZ 13 TSS

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270689214
Hospital Revenue Code	278
Min. Negotiated Rate	$1,430.33
Max. Negotiated Rate	$2,307.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,097.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33

STEM PRESS FIT SZ 13 TSS

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270689214
Hospital Revenue Code	278
Min. Negotiated Rate	$229.81
Max. Negotiated Rate	$4,767.75
Rate for Payer: Aetna Commercial	$3,623.49
Rate for Payer: Aetna Medicare Advantage	$2,860.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,431.55
Rate for Payer: Cigna Commercial	$4,767.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,097.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33
Rate for Payer: UnitedHealthcare Community & State	$229.81
Rate for Payer: Wellpoint Medicaid Managed Care	$252.69

STEM PRESS FT SZ 12 TSS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690434
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.21
Max. Negotiated Rate	$1,915.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,741.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21

STEM PRESS FT SZ 12 TSS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690434
Hospital Revenue Code	278
Min. Negotiated Rate	$190.75
Max. Negotiated Rate	$3,957.38
Rate for Payer: Aetna Commercial	$3,007.61
Rate for Payer: Aetna Medicare Advantage	$2,374.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,018.26
Rate for Payer: Cigna Commercial	$3,957.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,741.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21
Rate for Payer: UnitedHealthcare Community & State	$190.75
Rate for Payer: Wellpoint Medicaid Managed Care	$209.74

STEM PRESS TSS SZ 11

Facility

$7,711.70

Service Code	HCPCS C1776
Hospital Charge Code	270689674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,156.76
Max. Negotiated Rate	$1,866.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,542.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,866.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,696.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,156.76

STEM PRESS TSS SZ 11

Facility

$7,711.70

Service Code	HCPCS C1776
Hospital Charge Code	270689674
Hospital Revenue Code	278
Min. Negotiated Rate	$185.85
Max. Negotiated Rate	$3,855.85
Rate for Payer: Aetna Commercial	$2,930.45
Rate for Payer: Aetna Medicare Advantage	$2,313.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,966.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,966.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,542.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,966.48
Rate for Payer: Cigna Commercial	$3,855.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,866.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,696.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,156.76
Rate for Payer: UnitedHealthcare Community & State	$185.85
Rate for Payer: Wellpoint Medicaid Managed Care	$204.36

STEM PRIMARY EXTEN 11MM L65MM

Facility

$2,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270683577
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

STEM PRIMARY EXTEN 11MM L65MM

Facility

$2,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270683577
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

STEM PRIM I BEAM ANG *******

Facility

$954.00

Hospital Charge Code	270606320
Hospital Revenue Code	272
Min. Negotiated Rate	$143.10
Max. Negotiated Rate	$143.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.10

STEM PRIM I BEAM ANG *******

Facility

$954.00

Hospital Charge Code	270606320
Hospital Revenue Code	272
Min. Negotiated Rate	$22.99
Max. Negotiated Rate	$477.00
Rate for Payer: Aetna Commercial	$362.52
Rate for Payer: Aetna Medicare Advantage	$286.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.27
Rate for Payer: Cigna Commercial	$477.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.20
Rate for Payer: Oxford Commercial	$190.80
Rate for Payer: Qualcare PPO/HMO/WC	$143.10
Rate for Payer: UnitedHealthcare Commercial	$190.80
Rate for Payer: UnitedHealthcare Community & State	$22.99
Rate for Payer: Wellpoint Medicaid Managed Care	$25.28

STEM PROFEMUR TI 127D SZ1

Facility

$16,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270697656
Hospital Revenue Code	278
Min. Negotiated Rate	$2,431.50
Max. Negotiated Rate	$3,922.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,922.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,566.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,431.50

Know your out-of-pocket cost for care.

All Charges