Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STNT HRCULNK PLS 1008020-15

Facility

$4,750.00

Hospital Charge Code	280644282V
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STNT VIABAHN 5X5 120 VBJ050502

Facility

$14,710.00

Hospital Charge Code	270648634C
Hospital Revenue Code	278
Min. Negotiated Rate	$354.51
Max. Negotiated Rate	$7,355.00
Rate for Payer: Aetna Commercial	$5,589.80
Rate for Payer: Aetna Medicare Advantage	$4,413.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,751.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,751.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,942.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,751.05
Rate for Payer: Cigna Commercial	$7,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,559.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,236.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,206.50
Rate for Payer: UnitedHealthcare Community & State	$354.51
Rate for Payer: Wellpoint Medicaid Managed Care	$389.81

STNT VIABAHN 5X5 120 VBJ050502

Facility

$14,710.00

Hospital Charge Code	270648634C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,206.50
Max. Negotiated Rate	$3,559.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,942.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,559.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,236.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,206.50

STNT VIABHN 5X10 120 VBJ051002

Facility

$16,760.00

Hospital Charge Code	270648635C
Hospital Revenue Code	278
Min. Negotiated Rate	$403.92
Max. Negotiated Rate	$8,380.00
Rate for Payer: Aetna Commercial	$6,368.80
Rate for Payer: Aetna Medicare Advantage	$5,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,273.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,273.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,352.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,273.80
Rate for Payer: Cigna Commercial	$8,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,055.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,687.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,514.00
Rate for Payer: UnitedHealthcare Community & State	$403.92
Rate for Payer: Wellpoint Medicaid Managed Care	$444.14

STNT VIABHN 5X10 120 VBJ051002

Facility

$16,760.00

Hospital Charge Code	270648635C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,514.00
Max. Negotiated Rate	$4,055.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,352.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,055.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,687.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,514.00

STNT VIABHN 6X10X120 VBJ061002

Facility

$19,270.00

Service Code	HCPCS C1876
Hospital Charge Code	270648638C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,890.50
Max. Negotiated Rate	$4,663.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,854.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,663.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,239.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,890.50

STNT VIABHN 6X10X120 VBJ061002

Facility

$19,270.00

Service Code	HCPCS C1876
Hospital Charge Code	270648638C
Hospital Revenue Code	278
Min. Negotiated Rate	$464.41
Max. Negotiated Rate	$9,635.00
Rate for Payer: Aetna Commercial	$7,322.60
Rate for Payer: Aetna Medicare Advantage	$5,781.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,913.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,913.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,854.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,913.85
Rate for Payer: Cigna Commercial	$9,635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,663.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,239.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,890.50
Rate for Payer: UnitedHealthcare Community & State	$464.41
Rate for Payer: Wellpoint Medicaid Managed Care	$510.65

STNT VIABHN 6X5X120 VBJ060502

Facility

$14,710.00

Service Code	HCPCS C1876
Hospital Charge Code	270648637N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,206.50
Max. Negotiated Rate	$3,559.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,942.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,559.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,236.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,206.50

STNT VIABHN 6X5X120 VBJ060502

Facility

$17,615.00

Service Code	HCPCS C1876
Hospital Charge Code	270648637C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,642.25
Max. Negotiated Rate	$4,262.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,523.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,262.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,875.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,642.25

STNT VIABHN 6X5X120 VBJ060502

Facility

$14,710.00

Service Code	HCPCS C1876
Hospital Charge Code	270648637N
Hospital Revenue Code	278
Min. Negotiated Rate	$354.51
Max. Negotiated Rate	$7,355.00
Rate for Payer: Aetna Commercial	$5,589.80
Rate for Payer: Aetna Medicare Advantage	$4,413.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,751.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,751.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,942.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,751.05
Rate for Payer: Cigna Commercial	$7,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,559.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,236.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,206.50
Rate for Payer: UnitedHealthcare Community & State	$354.51
Rate for Payer: Wellpoint Medicaid Managed Care	$389.81

STNT VIABHN 6X5X120 VBJ060502

Facility

$17,615.00

Service Code	HCPCS C1876
Hospital Charge Code	270648637C
Hospital Revenue Code	278
Min. Negotiated Rate	$424.52
Max. Negotiated Rate	$8,807.50
Rate for Payer: Aetna Commercial	$6,693.70
Rate for Payer: Aetna Medicare Advantage	$5,284.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,491.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,491.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,523.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,491.82
Rate for Payer: Cigna Commercial	$8,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,262.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,875.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,642.25
Rate for Payer: UnitedHealthcare Community & State	$424.52
Rate for Payer: Wellpoint Medicaid Managed Care	$466.80

STNT VIABHN 7X10X120 VBJ071002

Facility

$16,350.00

Service Code	HCPCS C1876
Hospital Charge Code	270647585N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,452.50
Max. Negotiated Rate	$3,956.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,597.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50

STNT VIABHN 7X10X120 VBJ071002

Facility

$18,350.00

Service Code	HCPCS C1876
Hospital Charge Code	270647585
Hospital Revenue Code	278
Min. Negotiated Rate	$2,752.50
Max. Negotiated Rate	$4,440.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,440.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,037.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,752.50

STNT VIABHN 7X10X120 VBJ071002

Facility

$18,350.00

Service Code	HCPCS C1876
Hospital Charge Code	270647585
Hospital Revenue Code	278
Min. Negotiated Rate	$442.24
Max. Negotiated Rate	$9,175.00
Rate for Payer: Aetna Commercial	$6,973.00
Rate for Payer: Aetna Medicare Advantage	$5,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,679.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,679.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,679.25
Rate for Payer: Cigna Commercial	$9,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,440.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,037.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,752.50
Rate for Payer: UnitedHealthcare Community & State	$442.24
Rate for Payer: Wellpoint Medicaid Managed Care	$486.27

STNT VIABHN 7X10X120 VBJ071002

Facility

$16,350.00

Service Code	HCPCS C1876
Hospital Charge Code	270647585N
Hospital Revenue Code	278
Min. Negotiated Rate	$394.04
Max. Negotiated Rate	$8,175.00
Rate for Payer: Aetna Commercial	$6,213.00
Rate for Payer: Aetna Medicare Advantage	$4,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,169.25
Rate for Payer: Cigna Commercial	$8,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,597.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50
Rate for Payer: UnitedHealthcare Community & State	$394.04
Rate for Payer: Wellpoint Medicaid Managed Care	$433.27

STNT VIA BHN 7X5X120 VBJ071502

Facility

$19,950.00

Service Code	HCPCS C1876
Hospital Charge Code	270648641C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,992.50
Max. Negotiated Rate	$4,827.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,827.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,389.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,992.50

STNT VIA BHN 7X5X120 VBJ071502

Facility

$19,950.00

Service Code	HCPCS C1876
Hospital Charge Code	270648641C
Hospital Revenue Code	278
Min. Negotiated Rate	$480.80
Max. Negotiated Rate	$9,975.00
Rate for Payer: Aetna Commercial	$7,581.00
Rate for Payer: Aetna Medicare Advantage	$5,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,087.25
Rate for Payer: Cigna Commercial	$9,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,827.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,389.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,992.50
Rate for Payer: UnitedHealthcare Community & State	$480.80
Rate for Payer: Wellpoint Medicaid Managed Care	$528.67

STNT XPRT BLRY 4X60X80 2051601

Facility

$8,500.00

Hospital Charge Code	270638224V
Hospital Revenue Code	278
Min. Negotiated Rate	$204.85
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$204.85
Rate for Payer: Wellpoint Medicaid Managed Care	$225.25

STNT XPRT BLRY 4X60X80 2051601

Facility

$8,500.00

Hospital Charge Code	270638224V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

STOCK ANTI-EM KNEE ALL SZES***

Facility

$10.00

Hospital Charge Code	8000069
Hospital Revenue Code	279
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.00
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

STOCK ANTI-EM KNEE ALL SZES***

Facility

$10.00

Hospital Charge Code	8000069
Hospital Revenue Code	279
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

STOCK ANTI-EM KNEE LG L

Facility

$18.71

Hospital Charge Code	270302986
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.36
Rate for Payer: Aetna Commercial	$7.11
Rate for Payer: Aetna Medicare Advantage	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.77
Rate for Payer: Cigna Commercial	$9.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.61
Rate for Payer: Oxford Commercial	$3.74
Rate for Payer: Qualcare PPO/HMO/WC	$2.81
Rate for Payer: UnitedHealthcare Commercial	$3.74
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

STOCK ANTI-EM KNEE LG L

Facility

$18.71

Hospital Charge Code	270302986
Hospital Revenue Code	270
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.81

STOCK ANTI-EM KNEE LG R

Facility

$22.45

Hospital Charge Code	270302985
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

STOCK ANTI-EM KNEE LG R

Facility

$22.45

Hospital Charge Code	270302985
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

Know your out-of-pocket cost for care.

All Charges