Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEM RADIAL ALIGN 9 MM X 0 MM

Facility

$9,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270678337
Hospital Revenue Code	278
Min. Negotiated Rate	$235.58
Max. Negotiated Rate	$4,887.50
Rate for Payer: Aetna Commercial	$3,714.50
Rate for Payer: Aetna Medicare Advantage	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,492.62
Rate for Payer: Cigna Commercial	$4,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,150.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25
Rate for Payer: UnitedHealthcare Community & State	$235.58
Rate for Payer: Wellpoint Medicaid Managed Care	$259.04

STEM RADIAL ALIGN 9 MM X 0 MM

Facility

$9,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270678337
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.25
Max. Negotiated Rate	$2,365.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,150.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25

STEM RADIAL ALIGN 9MMx0MM

Facility

$9,775.00

Hospital Charge Code	270378337
Hospital Revenue Code	278
Min. Negotiated Rate	$235.58
Max. Negotiated Rate	$4,887.50
Rate for Payer: Aetna Commercial	$3,714.50
Rate for Payer: Aetna Medicare Advantage	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,492.62
Rate for Payer: Cigna Commercial	$4,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,150.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25
Rate for Payer: UnitedHealthcare Community & State	$235.58
Rate for Payer: Wellpoint Medicaid Managed Care	$259.04

STEM RADIAL ALIGN 9MMx0MM

Facility

$9,775.00

Hospital Charge Code	270378337
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.25
Max. Negotiated Rate	$2,365.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,150.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25

STEM RADIAL ALIGN 9X4MM

Facility

$11,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270697687
Hospital Revenue Code	278
Min. Negotiated Rate	$287.63
Max. Negotiated Rate	$5,967.50
Rate for Payer: Aetna Commercial	$4,535.30
Rate for Payer: Aetna Medicare Advantage	$3,580.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,043.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,043.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,043.43
Rate for Payer: Cigna Commercial	$5,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,625.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.25
Rate for Payer: UnitedHealthcare Community & State	$287.63
Rate for Payer: Wellpoint Medicaid Managed Care	$316.28

STEM RADIAL ALIGN 9X4MM

Facility

$11,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270697687
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.25
Max. Negotiated Rate	$2,888.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,625.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.25

STEM REVISION D 18MM x200 MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682980
Hospital Revenue Code	278
Min. Negotiated Rate	$674.80
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$10,640.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00
Rate for Payer: UnitedHealthcare Community & State	$674.80
Rate for Payer: Wellpoint Medicaid Managed Care	$742.00

STEM REVISION D 18MM x200 MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682980
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM REV STR SPLINE 12 X 135MM

Facility

$12,506.25

Service Code	HCPCS C1776
Hospital Charge Code	270690147
Hospital Revenue Code	278
Min. Negotiated Rate	$301.40
Max. Negotiated Rate	$6,253.12
Rate for Payer: Aetna Commercial	$4,752.38
Rate for Payer: Aetna Medicare Advantage	$3,751.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,189.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,189.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,501.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,189.09
Rate for Payer: Cigna Commercial	$6,253.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,026.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,751.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.94
Rate for Payer: UnitedHealthcare Community & State	$301.40
Rate for Payer: Wellpoint Medicaid Managed Care	$331.42

STEM REV STR SPLINE 12 X 135MM

Facility

$12,506.25

Service Code	HCPCS C1776
Hospital Charge Code	270690147
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.94
Max. Negotiated Rate	$3,026.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,501.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,026.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,751.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.94

STEM SECUREFIT SZ11 40MM

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270692257
Hospital Revenue Code	278
Min. Negotiated Rate	$287.70
Max. Negotiated Rate	$5,968.90
Rate for Payer: Aetna Commercial	$4,536.36
Rate for Payer: Aetna Medicare Advantage	$3,581.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,044.14
Rate for Payer: Cigna Commercial	$5,968.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67
Rate for Payer: UnitedHealthcare Community & State	$287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$316.35

STEM SECUREFIT SZ11 40MM

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270692257
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.67
Max. Negotiated Rate	$2,888.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67

STEM SECURE R FIT 127 #6

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691975
Hospital Revenue Code	278
Min. Negotiated Rate	$287.70
Max. Negotiated Rate	$5,968.90
Rate for Payer: Aetna Commercial	$4,536.36
Rate for Payer: Aetna Medicare Advantage	$3,581.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,044.14
Rate for Payer: Cigna Commercial	$5,968.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67
Rate for Payer: UnitedHealthcare Community & State	$287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$316.35

STEM SECURE R FIT 127 #6

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691975
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.67
Max. Negotiated Rate	$2,888.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67

STEM SECUR-FIT MAX 127 HIP #7

Facility

$11,662.80

Service Code	HCPCS C1776
Hospital Charge Code	270693033
Hospital Revenue Code	278
Min. Negotiated Rate	$281.07
Max. Negotiated Rate	$5,831.40
Rate for Payer: Aetna Commercial	$4,431.86
Rate for Payer: Aetna Medicare Advantage	$3,498.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,974.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,974.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,332.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,974.01
Rate for Payer: Cigna Commercial	$5,831.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,565.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.42
Rate for Payer: UnitedHealthcare Community & State	$281.07
Rate for Payer: Wellpoint Medicaid Managed Care	$309.06

STEM SECUR-FIT MAX 127 HIP #7

Facility

$11,662.80

Service Code	HCPCS C1776
Hospital Charge Code	270693033
Hospital Revenue Code	278
Min. Negotiated Rate	$1,749.42
Max. Negotiated Rate	$2,822.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,332.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,565.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.42

STEM SECURFIT SZ11 40MM 170MM

Facility

$11,449.40

Service Code	HCPCS C1776
Hospital Charge Code	270694831
Hospital Revenue Code	278
Min. Negotiated Rate	$275.93
Max. Negotiated Rate	$5,724.70
Rate for Payer: Aetna Commercial	$4,350.77
Rate for Payer: Aetna Medicare Advantage	$3,434.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,919.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,919.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,289.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,919.60
Rate for Payer: Cigna Commercial	$5,724.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,770.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,518.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.41
Rate for Payer: UnitedHealthcare Community & State	$275.93
Rate for Payer: Wellpoint Medicaid Managed Care	$303.41

STEM SECURFIT SZ11 40MM 170MM

Facility

$11,449.40

Service Code	HCPCS C1776
Hospital Charge Code	270694831
Hospital Revenue Code	278
Min. Negotiated Rate	$1,717.41
Max. Negotiated Rate	$2,770.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,289.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,770.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,518.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.41

STEM SECUR MAX 127 DEG #8

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270692080
Hospital Revenue Code	278
Min. Negotiated Rate	$287.70
Max. Negotiated Rate	$5,968.90
Rate for Payer: Aetna Commercial	$4,536.36
Rate for Payer: Aetna Medicare Advantage	$3,581.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,044.14
Rate for Payer: Cigna Commercial	$5,968.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67
Rate for Payer: UnitedHealthcare Community & State	$287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$316.35

STEM SECUR MAX 127 DEG #8

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270692080
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.67
Max. Negotiated Rate	$2,888.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67

STEM SHORT HUMERAL 10SZ

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691232
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

STEM SHORT HUMERAL 10SZ

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691232
Hospital Revenue Code	278
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

STEM, SHOULDER RESURF. DIA. 11

Facility

$4,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270680384
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

STEM, SHOULDER RESURF. DIA. 11

Facility

$4,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270680384
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STEM SMOOTH 14x80MM

Facility

$8,565.00

Service Code	HCPCS C1776
Hospital Charge Code	270677285
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

Know your out-of-pocket cost for care.

All Charges